It is not “woman”, but “transgender”, that is a truly elusive term, and how this relates to the statistics of trans youth suicide

Gender ideology claims that anyone who identifies as the opposite sex or a different gender, whether they have gender dysphoria  or have “transitioned” into their chosen identity in any way or not, they qualify for automatic inclusion under the umbrella term “trans” which is short for “transgender”.

Normally, I wouldn’t concern myself with how people identify, after all, identity is personal. However, gender ideology has grown into a political movement whose aims can be summarised in the following, often repeated, conversation between feminists and trans activists:

trans activist: People should be accepted and allowed to be who they are, without fear of discrimination.

feminist: Agree.

trans activist: Nobody should be forced to identify with the gender that’s been imposed on them since birth.

feminist: Strongly agree!

trans activist: Half of all young trans people have attempted suicide. Therefore we must remove all medical and legal obstacles for trans-identified people and children to access gender-reassignment treatments such as puberty blockers, cross-sex hormones and various degrees of reconstructive surgery.

feminist: Wait, what?

trans activist: Trans person doesn’t just identify as a gender, their gender identity is evidence that they were born in the wrong body.

feminist: What are you on about, mate?

trans activist: Transwomen are women, their penises are female, and they are discriminated against just like all other women, so they must be given full inclusion into female-only spaces and all the initiatives designed to protect women.

feminist: Transwomen are men. Sex is determined at conception and it can’t be changed.

trans activist: Omg you are so transphobic! You are a TERF. Check your cis-privilege.

So let’s take a look at the various groups of people who are included under the trans umbrella: gender dysphoric homosexual men; gender dysphoric women and children who may or may not be homosexual or survivors of sexual trauma; heterosexual men who get so aroused by the thought of being women, they seek to “become” them; male cross-dressers; people who believe they were “born in the wrong body”; gender non-conforming children and adults; children and adults who are struggling with sex or gender ambivalence in context of mental illness; male athletes who identify as female and go on to dominate women’s sports; men who identify as women so they qualify for positions on all-women shortlists; men who identify as women so they gain access to vulnerable women and girls for purposes of voyeurism, exhibitionism or violence; male sex offenders who identify as women so they get transferred to women’s prisons…This is not an exhaustive list, but it illustrates just how broad a term “trans” is.

I don’t dispute the existence of any of the above. This doesn’t mean that I agree with all of them. Questioning who is really trans, who isn’t, and what “being trans” means in material reality, allows us to better understand trans people and help them fight discrimination they no doubt experience. It can also help us to safeguard the vulnerable.

Some of the leading charities involved in trans activism define “trans” or “transgender” in the following way:



This may sound progressive at first glance, but there’s a problem. Their basic premise – that our sex is “assigned at birth” – is  false.

Everyone, including most people with disorders of sexual development (intersex), has their sex simply observed at birth. In rare cases, such as CAIS, sex can be observed wrongly. In the past, some intersex babies were “assigned sex at birth”  in order to raise them in one of the two gender roles, hoping that when they grew up, their inner sense of whether they were male or female (gender identity) will match. This sometimes worked, other times it resulted in catastrophic outcomes, but either way, this is where the term “sex assigned at birth” originates from.

It is argued that only 0.018% of the population are intersex, and these disorders are sex specific. 99.98% of the population fall squarely into one of the two easily observable and unambiguous sex categories – male or female.

It also bears saying that intersex community has repeatedly tried to distance themselves from the trans narrative.

Therefore, it is my opinion that by erroneously applying the term “sex assigned at birth” to the population that has its sex observed at birth, trans activists are conflating two distinct populations in order to assert primacy of “internal, personal sense of being” over the material reality of sex.

Another problem with the definition of “trans” is that it hinges on this “internal, personal sense of being”, which is fluid, mood dependent, situational and there is no objective way to verify or disprove it.

This has resulted in not only the alphabet soup LGBTQQICAPF2K+ , an acronym used to describe the current state of what used to be the gay and lesbian community, but in an explosion of new genders.

One might be forgiven for asking how are these genders any different from personality, interests or preferences? The answer is – they aren’t, but if this is what “gender” means these days, then we have as many genders as we have people on the planet. As you can imagine, new genders are often accompanied by special pronouns, but feel free to google those, because I have to move on with my point.

To define anything, we need to be able to objectively determine what is It that we are defining, and what is not-It. Because including not-It in the sample of It, will result in the definition of It being either wrong or meaningless.

This is exactly what happened when trans ideology started re-defining women – adult human females with XX chromosomes – to include men – adult human males with XY chromosomes – who identify as women. They rendered the definition of “woman” meaningless, and by making it dependant on men’s “internal, personal sense of being”, they also made it elusive.

However, it is not “woman”, but “trans” itself that is elusive, because “woman” is a sex designation that already has a definition in material reality, while “trans”, does not.

Because “trans” cannot exist without “cis”, trans ideology defines “cis” as  “someone whose gender identity is the same as the sex they were assigned at birth. Non-trans is also used by some people”.  This is how trans ideology not only re-defines sex of 99% of the population by “internal, personal sense of being” of the 1%, but it also reinforces social stereotypes as something everyone who is “non-trans” automatically identifies with.

This has given rise to claims by white heterosexual trans-identified men or “trans-lesbians”, that they are oppressed by black women who have “cis” privilege over them. This is where trans movement typically likens itself to the Civil Rights Movement, because we all know that was all about white people in blackface claiming not only that they are black, but that black people enjoy “black privilege” over them because they don’t have to perform blackface. Forgive my sarcasm, but at this point in the conversation with trans activists, I start to lose patience.

It’s unsurprising that when asked to define “trans” without using “I am what I am because I am” circular argument, trans activists refuse to answer because “their existence is not up for debate”, and call those who asked “transphobic” and “bigoted”. This is similar to the response we’ve been getting from priests – you must have faith in God, which we get to define without offering any proof other than our inner feeling and conviction, and questioning us is heresy. Similarly, trans activists are not only asking us to believe them, they are asking us to believe in them as agents of truth.

And because trans ideology demands blind belief and seeks to swiftly punish non-believers, it is far from an innocent phenomenon that isn’t hurting anyone.

So far, trans ideology has nearly destroyed sex-based protections for women, which are needed to mitigate the effects of male violence. It maligns lesbians for refusing to accept trans-identified men as sexual partners. Children who are deemed to be “trans” are now being given treatments that jeopardise their development. Trans-identifying adults routinely go on to have some degree of gender reassignment, which involves medications and procedures that can cause increased morbidity and mortality. If only this approach to curing feelings worked – by improving the overall quality of life, for example – but it doesn’t.


Psychiatric symptoms, including suicide, are known to be higher in gender dysphoric people compared with the general population, and they can worsen post gender reassignment. This is especially relevant because the bulk of trans activism focuses on obtaining easier and earlier access to these treatments, and anyone who tries to delay requests for medical interventions until the reasons behind them can be adequately explored, risks being accused of “literally killing trans people”.

Trans activists substantiate those accusations by claiming that “half of young trans people have attempted suicide”.  This is an effective silencing tactic because it directly accuses non-believers of causing suicide, and people who question trans ideology, and particularly its fixation on medically and surgically transitioning young people, are doing so out of concern for the welfare of those young people.

However, those accusations are not only manipulative by nature, they are also based on false statistics.



Anyone who dealt with the issue of suicide attempts knows that not all are serious attempts to end one’s life. A lot of them are cries for help, and in some cases they might even be an abuse or manipulation tactic. How we respond to them depends on the context.

This is not to say we shouldn’t act from the place of compassion, or that we should dismiss anyone, it’s just a reminder that if we’re analysing risk to population groups, such as trans youth for example, we need to have good studies and thorough understanding of what the figures mean, rather than take them at face value, or even worse, misrepresent them to suit our agenda.

Suicide statistics tend to break the results down by age, sex and method only, and it is difficult to speculate about causes, but it is estimated that 90% of suicides are associated with a psychiatric condition.

Most studies that explore the issue of youth trans suicide focus on suicidal ideation and attempts, in context of gender dysphoria. Reports of suicide attempts can be corroborated, but suicidal ideation, which usually relies on self-reporting, is much more difficult to assess, especially if we are unable to conduct the full Mental State Examination, such as would be the case if we relied on a survey for our results. Surveys can also be skewed by asking suggestible people leading questions, or by targeting specific population, employing selection bias to generate results, then reverse-applying these results to a much larger population without any evidence that the two populations are comparable. To liken this to a physical symptom, it’s like taking a population of people who are hospitalised due to persistent cough and analysing their incidence of TB, and then claiming that incidence of TB in all people who ever coughed was the same or similar.

Suicidal ideation is a common symptom, less so when it’s persistent. Suicide attempts are rare, and when they occur, most of them are “parasuicide attempts”, rather than genuine attempts at ending one’s life. Serious suicide attempts are even rarer, and are almost always diagnostic of mental illness.

Evidence suggests that mental illness, and especially depression, anxiety, bipolar and dissociative disorder, is present in  70% of individuals  with gender dysphoria, either concurrently or at some time during their lifetime. Which brings me to another way by which suicidality in trans youth can be misinterpreted – by diagnosing them incorrectly.

In psychiatry, there exists a hierarchy of diagnoses.


I’d also like to mention psychiatric symptom of ambivalence, which is particularly distressing when it involves one’s own body, sex, gender or sexuality. This ambivalence is not just wondering whether one might be attracted to the opposite sex as the normal stage in sexual development. This is ambivalence that arises from disordered thinking which characterises severe mental illness.

That a lot of mental illnesses tend to develop in youth, and are often accompanied by suicidal ideation and even attempts, illustrates the pitfall with trying to attribute suicidality to “being trans”. Mental illness doesn’t “co-occur” with transgenderism, in fact, symptoms which, in isolation, might justify someone’s inclusion under transgender umbrella, in context of mental illness higher up in the hierarchy, are more likely just symptoms of that illness.

This is important because if the person with mental illness is misdiagnosed as “trans”, and instead of being given treatment for mental illness is fast-tracked down the path of gender transition, it can severely impact their life.

There is a great book written by Walter Heyer , who himself detransitioned (male-to-female-back to male), that talks about this issue, as well as this survey of female detransitioners. 

I’ve looked after a few trans patients who were admitted to the psychiatric ward on 1:1 suicide watch, due to repeated and relentless suicide attempts following gender reassignment surgery. Most of them had history of suicidal ideation and suicide attempts. What stays with me after all these years is that they were some of the most distressed patients I have ever seen. Their distress wasn’t only in realising that gender reassignment didn’t cure their troubling feelings, but in the fact that they now had to live with their bodies being mutilated irreversibly. It goes without saying that severe psychological distress doesn’t lend itself to the kind of self-care most of these procedures require post-op, which can lead to increased complications which further impact on the patient’s life in an iatrogenic (doctor-caused) vicious cycle that could’ve been avoided.

These patients, and many others who suffer worsening physical and metal health following gender transition, are currently swiped under the rug, silenced like gender-critical people, and institutions are obstructing research into phenomenon of detransition, under the same accusations of heresy against trans ideology.

All this illustrates that not only is it unacceptable for trans activists to use vague definitions of what “trans” is, or to generate false statistics in order to emotionally blackmail their way into deregulating the very process of transition, doctors, hormone specialists and plastic surgeons should not be giving gender reassignment treatments to people who have suicidal ideation, history of suicide attempts and/or serious mental illness. Not only because it can make psychiatric symptoms worse, but because they have ethical and moral responsibility to protect vulnerable patients from making decisions that can harm them.

Time and again I come back to this connection between trans ideology trying to render terms such as “woman” meaningless, and their fixation on “curing” suicidality with hormones and surgery. One explanation that comes to mind is that women, or more precisely feminists, have been some of the most vocal critics of both harmful power structures in the society and the concepts of “gender”, “innate gender identity” and initiatives that force gender non-conforming people and children into rigid gender boxes. And that’s what transgenderism ultimately does, instead of working to dismantle systemic injustice and with it, the gender boxes themselves, or attempting to analyse how gender stereotypes harm gender non-conforming children and adults, it seeks to obliterate gender non-conformance itself by constructing endless new and unique gender boxes. And while a tiny minority of people will identify and alter their appearance to fit one of the new genders, most people and especially heterosexual women will be labelled as “identifying” with their own oppression in the sexist society.

That up to 88% of young people who claim to be trans desist and most of them grow up to be gay, further raises the issue of homophobia and gay erasure within the trans movement.

The rapid rate at which trans ideology is obliterating women’s rights, and making gender non-conforming people into life-long medical patients, should give us all a pause. As always, we must ask ourselves, who does this benefit and who does this harm?

ADDED 26.4.19: Just discovered this article, it was written in 2016 so things have escalated from there, but it echoes a lot of what I discussed here. It is also one of the best articles on the subject I have come across so far:

Gender Dysphoria and Surgical Abuse by John Whitehall, Professor of Paediatrics at Western Sydney University

16 thoughts on “It is not “woman”, but “transgender”, that is a truly elusive term, and how this relates to the statistics of trans youth suicide

  1. Shauna says:

    A thorough, measured and pragmatic analysis highlighting how it’s not that “believers” don’t get it, it’s that they just WON’T get it, truth be damned. Brava, Doctor. Excellent as always. Thank you!

    Liked by 4 people

  2. ramendik says:

    The obligatory link to a non-peer-reviewed screed by Roman Catholic bigot Paul McHugh, known for defending paedophile priests, gives the game away.

    Anti-transitionism is like anti-vaxxerism, a movement against mainstream life-saving medicine. And there are anti-vaxxers doctors too. I wonder when the two will meet and create a theory how thiomersal causes transgender ideation.


    1. la scapigliata says:

      Being cautious not to harm gender dysphoric children and adults with unnecessery and potentially damaging medical procedures is not “anti-transitionism”, you’re just evoking the latest on the long list of heresy accusations I addressed in my post. Mentioning anti-vaxxers in the same breath just proves you are here to smear not engage in a debate, which is unsurprising.

      Thank you for the heads up about Paul McHugh, former chairman of the Department of Psychiatry and Behavioral Sciences at John Hopkins University School of Medicine.

      The link to his article is superfluous to this post. It was offered as a good opinion piece of somebody who was there when the gender reassignment was pioneered and who concluded that it didn’t really help, a sentiment that was echoed in the biggest study on transsexuals which is also quoted in the same sentence.

      I did not know that he once supported his colleague Dr Berlin who chose not to report crimes of his patients, on account of it damaging the chances of other sex offenders seeking treatment at their Sexual Disorders Clinic, because they believed engagement with their services helped stop these men from offending.

      Furthermore, it was Dr Berlin who quotes John Money and Alfred Kinsey as mentors, who were paedophile defenders.

      I have now removed the link, because even though the attitude of Dr McHugh is not uncommon in psychiatrists of his generation who worked with sex offenders, and not a proof that he himself ever protected paedophiles in the way you are suggesting, it is enough for me to not quote him.

      If you are concerned with association with paedophile defenders, however, you should concern yourself more with John Money who is literally the pioneer of gender reassignment and whose sexist theories are thriving within trans community, such as concepts “assigned sex at birth” (as I described in the article). Trans community has also embraced his reserch on sexual classification of hermaphrodites and erroneously applied it to people who have no issues with being sexed, producing a nonsensical body of work in which everyone’s sex is supposedly “fluid” just because there are people with abnormalities. The same trans community that shows morbid obsession with children’s sexed bodies, and who are wholeheartedly supporting abusive, semi-paedophillic programs about innocent children’s bodies and particularly genitals, being discussed in the name of trans ideology.

      If trans activists say children can meaningfully consent to sex change, are they not paving the way for someone saying that children can consent to sex? Trans ideology grooming children, trying to distance children from parents who won’t blindly allow their bodies to be harmed, is the real concern here.

      Liked by 4 people

  3. Georgina says:

    I hope this comment is nature’s as an attack . I think this article has some important things to say , and says many of them very well, but it’s sooo frustrating seeing an obvious end habitually repeated ” ideology before reality ” error repeated here in a way that compromises the accuracy , integrity and power of the article , and inadvertently plays into the fortean narrative tactics of those peddling kiddy transsex.

    It would be a really good article except for the woefully wrong intersex information . Why do so many academic feminists insist on replicating the already exposed errors perpetuated by Germain Greer’s deliberate fraud in the whole woman ? It’s not trivial , and it actually provides the vulnerability to discredit and collapse to anything otherwise convincing and insightful they might have offered to people beyond their bubble, including even those somewhat mesmerized by the current hegemony!

    When you offer people already gained to distrust you a very easy example to see you are obscuring some truth seemingly to support your argument , ( instead of dealing with complexity properly ) you’ve lost them .

    I was reminded of this yesterday again when revision cult dynamic theory . Purist dialogues that hide or evade certain truths can actually paradoxically make the naive followers isolated from those truths vulnerable to other extreme/ totalist positions , because the new position glows with the forbidden hidden truth. Hence why the students of academic feminism so readily provided the petrie dish in which wrong- body propaganda was hot- housed.

    It’s really disappointing to see otherwise fairly accurate and important perspectives being hobbled by the identity signalling self- sabotage of re- stating group- endorsed errors .

    It’s frustrating , and pointless. And it’s like ground hog day.

    Also a properly informed commentary on ” assigned at birth ” and its relationship to medical abuse of intersex children would provide a strong and truthful parallel point against the kiddy transsex industry .

    I’ll add too , that the deological frame chosen by most people in approaching the kiddy trans industry can make them blind to recognise that the ideological tactic of their opposition is Fortean , and as such is best dealt with not by shoehorning exceptions into categories inappropriately, nor by reductionism, but rather by a healthy and truthful willingness to matter- of – fact understand and address what exceptions do and don’t mean . Once you face the exceptions accurately, confidently , and openly , the Fortean ideological spell is neutralised.

    I do thank you for bravely tackling kiddy transsex. And I do appreciate your strong points. It’s just frustration in seeing that compromised ( in terms of outside your bubble impact) by such simple stale errors , that drives my the push these points a bit directly. I would happily contribute some editing suggestions re ” assigned at birth ” and intersex information if you did want to take this piece to another audience , and free it of the things that hobble it.

    Also Fortean counter- logic is the engine that drives their ideology machine .


  4. la scapigliata says:

    Hi Georgina. Thank you for your comment, even though I found it quite confusing. I assume English is not your first language, and it can be difficult to accurately express yourself. I can reassure you that information regarding intersex conditions is medically accurate. Also, you haven’t offered any examples of what it is you are actually objecting to, or why it should be considered “wrong” or “stale”. I’m a medical doctor, not a philosopher, so obviously would not be tackling this subject philosophically, but purely from medical ethics point of view. I’m happy with my logical conclusions and analysis of subjective nature of gender ideology. If you have something to contribute to gender debate, I would suggest opening a blog (it’s free) and writing a post about it.

    Liked by 4 people

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