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Ryan T. Anderson. When Harry Became Sally: Responding to the Transgender Moment. New York: Encounter Books, 2018. 251 pp. Hardcover, $19.31. ISBN: 978-1594039614.

when harry became sally andersonWhat does it mean to be male or female? What is sex and how is it related to gender? Does a person’s gender identity determine bodily sex or gendered experience? Can a man or woman really transition to become the opposite sex, and are sex reassignment surgeries successful? In his newest book, When Harry Became Sally: Responding to the Transgender Moment, Ryan T. Anderson tackles these and a myriad of other questions. Anderson, the William E. Simon Senior Research Fellow at the Heritage Foundation, defends the view that “the best biology, psychology, and philosophy all support an understanding of sex as a bodily reality, and of gender as a social manifestation of bodily sex. Biology isn’t bigotry” (p. 2). The strength of the book is that Anderson takes an all-inclusive approach, covering every dimension of the topic: gender and culture, politics, law, biology, medical practice, psychology, metaphysics, and more. There is no doubt that this is the most comprehensively researched book on transgenderism currently available.

Anderson commences his work by highlighting the ways in which American media and entertainment have raised awareness of transgenderism and pushed to normalize the movement and its ideas. From Caitlyn Jenner to Chastity Bono, from the documentary I Am Cait to the reality cable show I Am Jazz, from stories run by Fortune and National Geographic and everything in between, transgender individuals and their stories have been broadcast far and wide. In government, the Obama administration did its best to push transgenderism on the legal front, seeking to redefine “sex” in Title IX to include “gender identity” and reinterpret bans on sex discrimination as bans on gender identity discrimination. Meanwhile, medical universities and programs that once frowned upon transgender claims have since reversed course and now perform sex reassignment surgery. Even more concerning, practicing psychologists have been ousted and their clinics shuttered for their belief that children with gender dysphoria should not be immediately transitioned. Increasingly, in education, medicine, and even the military, professionals, government workers, and citizens have been dragged into a divisive ideological battle that has caused tremendous confusion, strain, and discord. America’s transgender moment has turned into a movement that threatens to sweep across our nation.

Chapter two unpacks the transgender worldview, exposing its basic—and ever changing—beliefs. Anderson highlights three findings: (1) transgender activists are always changing their beliefs and increasing their demands; (2) they are close-minded to contrary evidence; and (3) this narrow-mindedness lends itself toward coercion. Regarding ontology—in this case anthropology—transgender activists have changed their tune more times than one can count. Previously they referred to a transgender girl who identified as a boy or a transgender boy who identified as a girl, which assumed gender as a pliable social construct. Yet this way of speaking implicitly contrasted a person’s gender identity with their biological sex, undermining the idea that gender was the determining factor. So, advocates like the Human Rights Campaign have scratched this approach and now demand that gender identity be the essential determinant of a person’s sex. Thus, a transgender boy simply is a boy and a transgender girl is a girl. In line with this, transgender proponents no longer speak of biological sex; instead, this has morphed into “sex assigned at birth,” which has the effect of splitting sex from biology in order to prioritize gender identity as the crucial factor in determining human sexuality.

This flip-flopping is confusing. Gender used to be a social construct and sex was biologically binding; but now biological sex is the social construct imposed upon the hapless child at the time of their birth, while gender identity is the immutable characteristic upon which one’s sexual destiny depends. Which is it? Transgender activists cannot decide because they need both: in order for a person to transition from one gender to another (i.e., gender fluidity), gender identity must be subjectively determined and socially constructed and reconstructed; yet in order for gender identity to be scientifically studied, legally coded, and accepted by the public, it needs to have some semblance of permanence and objectivity beyond individual feelings and preference. Transgender activists try to have it both ways, but they cannot escape the glaring incoherence of their claims. This is just one of the many contradictions intrinsic to the transgender worldview that Anderson exposes.

This entire approach is radical, but not new: it subverts reality to a person’s subjective beliefs, desires, and feelings. In other words, reality—in this case human nature—is subjectively constructed, endlessly malleable to whatever the person wants it to be. Underlying this entire mess is an implicit neo-Gnosticism of a hedonistic nature: the person is dualistically divided between the real, immaterial self on the one hand and the material body on the other, but instead of shunning worldly pleasures as evil (as with ascetic Gnosticism of in the ancient world), the body is primarily viewed as the means by which to gratify the desires of the self. This is why transgender activists consider it justifiable to surgically change the body to match a person’s subjective gendered experience. Yet as Anderson points out, this is biologically and metaphysically impossible: you simply cannot change a person’s sex through sex reassignment surgery, despite what your feelings might say.

Anderson covers far more in his book than I can summarize in this review. Many issues he broaches are of grave concern. Transgender activists have gone to great lengths to reeducate the public, and especially children, about sex and gender, using absurd graphics such as “The Genderbread Person” or “The Gender Unicorn” to brainwash youth into accepting an unproven ideology. Transgenderism is also changing the way health professionals do medicine. Having bought into activist claims that children who are “consistent, persistent, and insistent” about their gender identity must begin transitioning, many medical experts now follow a four-step procedure: first comes social transitioning where new clothes, name, pronouns, and treatment of the child is prescribed; second, for children close to puberty, they will be placed on puberty blockers; third, by age sixteen, cross-sex hormones (estrogen or androgens) will be delivered; and fourth and finally, sex reassignment surgery is done after age eighteen. Tragically, this process is unnecessary as anywhere from 80-95% of children who express gender dysphoria will eventually come to identify with their natural bodily sex if simply left alone. When this startling statistic is combined with the reality that the suicide rate of those who do undergo gender transitioning is nineteen times higher than the general public, adopting the transitioning procedure above looks utterly foolish.

Although the entire book is excellent, I happen to think the most important chapter is chapter three where Anderson highlights the stories of six transgender persons who ended up regretting their decision to transition and eventually detransitioned. These stories are gut-wrenching—they simultaneously stir up deep compassion for these afflicted souls while also sparking indignation at a culture and ideological movement that has, in many cases, done irreparable harm toward those genuinely struggling with gender dysphoria. Most importantly, those with gender dysphoria are often in great anguish—feeling utterly disconnected from their bodies and pariahs in society. They have usually suffered some sort of trauma in their life, or endured misogyny and sex stereotypes. Sometimes the trauma was due to bullying, other times from losing a parent; in certain circumstances, parental figures would cross-dress them or lavish love upon their opposite-sex siblings while ignoring them. These kinds of mistreatments caused deep wounds and drove these children to fantasize about being the opposite sex as a way to cure their pain, what they later came to see as a gender dissociative disorder.

When they sought help, they found medical and health professionals not only eager to affirm their transgender identities, but pressuring them to transition as soon as possible. Few of these professionals stopped to genuinely listen to the needs of these conflicted individuals; instead it was assumed that their transgender identities were determinative and that changing the body was the only solution. Many of those wrestling with gender dysphoria trusted these professionals, but others also felt desperate: unable to live with their dysphoria and ready to commit suicide, they believed their only means of survival was to transition. They were never given another option, and they were blithely led to believe that hormonal and surgical treatments were safe and effective treatments. Yet when the transition failed to achieve the desired results, these transgender individuals felt deeply betrayed by their health advisors. One person called this kind of aid “a form of medical abuse.” Passages like this from a detransitioned youth are chilling:

You thought you were doing good but you were giving me tools to hurt myself. I thought I needed to come to you to get what I needed to be happy but I was wrong. We both had no idea what we were doing, what was really going on. Your good will didn’t end my suffering, it increased it…your kindness led to more scars, not less.

For many, they find they can no longer trust medical practitioners again. This underscores the urgency for health professionals to act professionally—to know the truth about human sexuality and gender, to be wary of the social contagion from fashionable identity movements, and to always abide by the Hippocratic Oath.

When they did transition, these individuals discovered that it didn’t live up to their expectations. All of them testified that at the time it felt right to transition, and that at first it brought temporary relief and seemed to be working. Over time, however, changes made to the body through hormonal or surgical treatment did not relieve their gender dysphoria, and it didn’t bring the peace and wholeness they were promised. When this truth sunk in, they came to regret their choice to transition, especially since for many lasting damage had been done to their bodies that they could not undo. For others, the entire process of transitioning itself became a deeply traumatic time in their lives. They learned that what feels easiest in the moment isn’t always right, and that their transgender identity was not the real them, nor was it innate or immutable. While their gender dysphasic experiences were real, transitioning was just an artificial coping mechanism that made things worse.

If they could rewind the tape and give their younger and more naïve selves advice, they would all say that transitioning isn’t the best way to deal with gender dysphoria, but that alternative treatments should be pursued. They would caution that we should be especially concerned about children, as most will outgrow the gender dysphoria of their youth. Children are not capable of understanding complex gender issues, nor are they mature enough to make drastic, life-changing decisions about their bodies. Those who detransitioned desperately want to spare children the pain they’ve suffered; and many of them excoriate the health professionals that helped them destroy themselves.

This part of Anderson’s project is crucial because we are narrative creatures, and other people’s stories resonate deeply with us. We each have a story of our own that we want people to listen to and empathize with, and so when we hear the stories of the detransitioned told in their own words, we cannot dismiss them as easily as we could a study or report. Tragically, however, these detransitioned persons are rarely heard in the public square, and when they do speak up they are often attacked and silenced because their testimonies rebuke the reigning ideology. After detransitioning, many live in secret, ashamed that they fell for the fraud of transgenderism. These are real people, and their stories are heart-breaking; they are not just statistics to be debated or thrown around in a culture war. Anderson tells their stories with passion and grace, and we would be wise to listen closely.

In the closing pages of his book Anderson seeks to guide us as to what we can do. He rightly cautions that when speaking of this issue, we must be careful not to stigmatize those suffering from gender dysphoria. In part, this requires expanding our understanding of what maleness and femaleness can include, and rejecting rigid, gender stereotypes that are overly myopic. Additionally, we ought to create a network of medical practitioners, clinicians, and mental health professionals that have not been captured by politically correct transgender ideology, and who are willing to give those struggling with gender dysphoria alternative treatments to transitioning. We need a new generation of scholars, teachers, professionals of various kinds, and common citizens who will engage the broader culture, defend the truth in the public square, and educate themselves and others about a healthy and sound understanding of gender and sexuality. Religious leaders can provide instruction to their congregants and sensitive pastoral care; meanwhile, lawyers and politicians can work to craft reliable public policy that will lead to genuine human flourishing. Anderson ends his book with a sobering warning:

What’s at stake in the transgender moment is the human person. If trans activists succeed in their political agenda, our nation’s children will be indoctrinated in a harmful ideology, and some will live by its lies about their own bodies, at great cost to themselves physically, psychologically, and socially. Lives will be ruined, but pointing out the damage will be forbidden. Dissent from the transgender worldview will be punished in schools, workplaces, and medical clinics. Trying to live in accordance with the truth will be made harder.

I would highly recommend this work. Anderson has delivered a definitive treatment on the contemporary phenomenon of transgenderism, its ideas and manifestations. He manages to be fair and compassionate without being vitriolic or demeaning; he speaks frankly at times and with a firmness and clarity the truth requires. This is no mean feat in an arena where the truth is being actively suppressed and those who speak up are censored, bullied, and attacked. It requires courage to take the public stand Anderson does, and we should be thankful for his tenacity and inspired to do likewise. As philosopher and social critic Os Guinness has argued in his recent book Impossible People, now is the time when our society needs Christians to be impossible in a good way: those who stand for the truth when the world is against them, who are not deterred in their convictions when the law is bearing down upon them, and who are courageously faithful when facing challenges and seductions to capitulate—and all with a gentleness, grace, and respect that brings glory to God. Ryan T. Anderson is one such impossible person. May his tribe increase.