What We Believe

Exposing the Fragility of Transgender Ideology: A Review Article

Andy Wilson

When Harry Became Sally: Responding to the Transgender Moment, by Ryan T. Anderson. Encounter, 2018, 264 pages, $16.99, paper.[1]

In February 2021, during the same week when the U.S. House of Representatives was renewing the effort to legislate transgender ideology through the Equality Act and when the Senate was holding confirmation hearings for the transgender appointee to the post of assistant secretary of the Department of Health and Human Resources, online retail giant Amazon cancelled Ryan T. Anderson’s acclaimed 2018 book When Harry Became Sally: Responding to the Transgender Moment. That is, the book was thoroughly erased from Amazon’s website and all of its platforms. This was a consequential move, as Amazon controls, by various metrics, between 50 and 80 percent of book sales in America. If Amazon refuses to sell certain kinds of books, publishers will likely be unwilling to publish such books. This is yet another example of a strategy that progressives employ as they strive to implement various aspects of their radical agenda for society: the strategy of making it very difficult for opposing arguments to get a fair hearing in the media.[2] As the publisher of Anderson’s book pointed out, “Big Tech and Big Media have become drunk with power and … have begun to regard Orwell’s Nineteen Eighty-Four as a how-to manual instead of what it is, a scarifying warning about the dangers of totalitarianism.”[3] When I learned that Anderson’s book had been memory-holed by Amazon, I ordered it directly from the publisher that very day. I am glad I did.

In a society that is truly dedicated to individual liberty and free speech, those who disagree with a particular argument will respond to it with an argument of their own. But in our society, proponents of transgenderism are unwilling to engage those who challenge their position. Instead, they typically denounce such people as dangerous bigots who need to be silenced. Why do they do this? Why not just refute the argument if it is so patently false and harmful? It certainly seems, to use the words of Queen Gertrude in Hamlet, that they “doth protest too much.”[4] Or as Anderson puts it, the fact that transgender activists constantly adapt their creed, expand their demands, refuse to engage contrary evidence, and employ coercion “suggests a posture of defensiveness—that activists know their claims can’t stand up to scrutiny” (28–29).

When Harry Became Sally begins by explaining the rise of transgender ideology, focusing especially on what has taken place at Johns Hopkins University over the past half-century. When a gender identity clinic was established there in 1965, a young professor of psychiatry at the school named Dr. Paul McHugh tried to dissuade his colleagues from treating gender dysphoria with transgender-affirming therapies, including “sex reassignment.” In Anderson’s words,

After studying the evidence, McHugh decided that sex change surgery was bad medicine and was “fundamentally cooperating with a mental illness.” Psychiatrists, he thought, could better help patients with gender dysphoria by “trying to fix their minds and not their genitalia.” (17)

His efforts were successful for a few decades, but in 2016 the school’s hospital once again began performing sex reassignment procedures. This move was not made in response to new scientific evidence that refuted McHugh’s arguments but because of political pressure and shifting cultural attitudes. Unfortunately, this was not an isolated event. In our cultural climate, anyone who tries to help those suffering from gender dysphoria understand why they are the way they are is likely to be deemed a bigot. This only demonstrates how “medical practice is seriously compromised by an ideological agenda” (24).

In chapters 2 and 3, Anderson looks at transgenderism through the eyes of both its advocates and its casualties. He explains how the public policies called for by transgender activists grow out of a radical conception of the human person that says that a person’s actual gender is rooted in their internal sense of gender identity, regardless of whether this corresponds to biological reality. This is reflected in the insistence that a person’s biological sex be referred to as the sex that they were “assigned” at birth and that gender transition be construed not as “sex change” but as a matter of affirming and settling into one’s true self. Activists zealously promote transgender educational efforts and public policies that police language, give transgender individuals access to facilities and activities reserved for the sex with which they identify, and provide gender transition therapy for children without parental consent. While these efforts have found a significant measure of success, the fact remains that “the core of the ideology is the radical claim that feelings determine reality” (48). As C.S. Lewis once observed, this is what happens when people reject the notion that nature has any given meaning or purpose: “All motives that claim any validity other than that of their felt emotional weight at a given moment have failed them. When all that says ‘it is good’ has been debunked, what says ‘I want’ remains.”[5]

In addition to pointing out the contradictions and inconsistencies of this way of thinking, Anderson devotes an entire chapter to the stories of “detransitioners,” people who found that gender transition did not solve their problems and eventually decided to pursue the course of learning to accept the reality of their biological sex. While such people are often attacked and silenced by trans activists, their stories provide valuable insight into why it is that suicide rates for those who have transitioned are nineteen times higher than those of the general population (73). These individuals attest to the fact that because transitioning fails to address the root problems, “it may actually deepen the alienation from one’s body” (75).

Chapter 4 sets forth the biology of sexual differentiation, making it clear that there is no biological basis for the claim that a man can be born in the bodily form of a woman. Sex is determined at fertilization and, with the exception of rare instances involving disorders of sexual development (DSDs), is easily recognized at birth. As Anderson points out, “The fundamental conceptual distinction between a male and a female is the organism’s organization for sexual reproduction” (79). There is also a wide array of secondary physical and cognitive sex differences between males and females that cannot be attributed to socialization. And as far as DSDs, these are not instances of a third sex but of people who are either male or female with a disorder in their development. In such cases, “The sound medical response is to identify the predominant underlying sex and then take measures to provide health and functioning, as far as possible, through hormones and possible surgery” (91). While transgender activists lobby for classifying these disorders as “Differences of Sexual Development,” we do not speak this way of other bodily disorders. If a person’s heart or digestive tract does not function the way it is supposed to function, it is not a matter of difference but a matter of disease. It is also important to note that “most people who have a DSD do not identify as transgender, and most people who do identify as transgender do not have a DSD” (92). In other words, DSDs cannot be used to support transgender ideology.

Chapter 5 begins by pointing out the alarmingly high rate of attempted suicides among people who identify as transgender, noting that the root problems behind those suicide attempts do not seem to be alleviated by sex reassignment procedures. And Anderson points out that these “poor outcomes can’t be blamed on a hostile or bigoted society, since they are reported even in cultures most accepting of people who identify as transgender” (93). The essence of gender dysphoria (which used to be referred to as “gender identity disorder”) is the delusion of thinking that one is the opposite of one’s biological sex. This is similar to the faulty assumption held by those who suffer from anorexia nervosa, who see themselves as overweight when they are actually dangerously thin. In both instances, the person’s feelings do not line up with reality. Instead of addressing gender dysphoria by focusing on treating the mind that is the source of the delusion, transgender ideology insists on changing the body to bring it in line with the person’s feelings. The sad reality is that this does not actually change the person’s sex. As Dr. McHugh explains, those who undergo transitioning treatment and procedures become “feminized men or masculinized women, counterfeits or impersonators of the sex with which they ‘identify’” (101). That being the case, it is not surprising that studies have found strong evidence of poor psychological outcomes for those who have undergone surgical transitioning.

In chapter 6, Anderson focuses on the most contentious issue in the controversy over transgender ideology: the push to encourage gender transitioning among children. For children who identify as transgender, transgender-affirming therapy involves social transition as soon as the child begins to express a transgender identity, puberty blockers at the approach of puberty, cross-sex hormones around age sixteen, and sex reassignment surgery around age eighteen. Proponents of this approach disregard the fact that “the vast majority of children with gender dysphoria—80 to 95 percent—naturally grow out of it, if they aren’t encouraged to transition” (119). Sadly, these chances are likely to be considerably diminished by transgender-affirming therapy, as “one would expect that the development of natural sex characteristics might contribute to the natural consolidation of one’s gender identity” (122). Why encourage children to persist in identifying as transgender when transitioning involves considerable risks and when the alternate approach of helping children work through the potential causes of their dysphoria has seen significant success? While transgender activists dismiss such approaches as “conversion therapy,” Anderson contends that it is “an Orwellian abuse of language to say that helping a child be comfortable in his own body is ‘conversion therapy,’ but transforming a boy into a ‘girl’ is simply allowing the child to be ‘her’ true self.” (142)

The book’s concluding chapters consider the cultural environment in which transgender ideology is gaining ascendancy and the effect this is having in the sphere of public policy. Anderson argues that the morphing of feminism into a movement that seeks to abolish sexual differences has fostered a misguided concept of gender in our culture, and this has opened the door to transgender ideology. While gender is not merely a social construct, it is socially shaped. In Anderson’s words,

Gender properly understood is a social manifestation of human nature, springing forth from biological realities, though shaped by rational and moral choice. Human beings are creatures of nature and of culture, but a healthy culture does not attempt to erase our nature as male and female embodied beings. Instead, it promotes the integrity of persons, in part by cultivating manifestations of sex differences that correspond to biological facts. (149)

As this way of thinking gives way to transgender ideology, attempts are being made to impose a radical transgender policy agenda. This agenda “entirely ignores competing interests and considerations” (181), most notably the privacy and safety of girls and women, and the natural advantages that biological males have over women in many sports. While this agenda is being implemented by reinterpreting “sex” in existing anti-discrimination legislation to include gender identity, Anderson shows how such a move is contrary to the original intent of such legislation, is unsupported by science, and compels many people to endorse and facilitate ideas and behavior that they consider to be false and immoral.

While media outlets like the New York Times and Washington Post have attacked Anderson’s book as hateful and bigoted,[6] it is actually a courageous, compassionate, and carefully researched effort to challenge a zealously-promoted ideology that is bringing great harm to people’s lives. Soon after the book’s cancellation by Amazon, one individual who struggles with gender dysphoria published an article attesting that Anderson and his book have been of great help to him, saying,

The arguments he makes are positioned within the compassionate and empathetic interest of a scientist trying to understand what is causing a person so much pain and what can truly be done to relieve it. Without ever dismissing the experience of the transgender person, he asks the important question, one I struggled with for years, of whether a medical transition is genuinely the best option to alleviate gender dysphoria and all the pain and suffering associated with it. … Anderson’s book asks necessary questions that deserve to be given fair consideration and debated, not restricted from public view.[7]

Amazon’s stated reason for banning the book from their platforms is that they have “chosen not to sell books that frame LGBTQ+ identity as a mental illness.” However, as Anderson pointed out in response, “Gender dysphoria is listed in the APA’s Diagnostic and Statistical Manual of Mental Disorders, which Amazon sells. So, the real deciding factor seems to be whether you endorse hormones and surgery as the proper treatment or counseling.”[8] People are being helped by having access to well-reasoned arguments like Anderson’s that expose the unscientific, metaphysical nature of the assumptions that underlie transgender ideology. The fact that this is so intolerable to trans activists suggests that their objective is not really to help those who suffer from gender dysphoria. If not, then what is their objective? To use identity politics to solidify their hold on the levers of cultural power? To create more consumers for the transitioning products and services on offer from the pharmaceutical and medical industries?

It is crucial for Christians to recognize what is going on here. As R. R. Reno points out, we have seen this strategy employed before:

The game plan is simple. Begin with an unobjectionable affirmation of our duty to care for the weak and vulnerable. Then use it as a hook to compel affirmations of progressive cultural politics. I saw this strategy employed in the Episcopal Church in the 1990s. Gay youth are vulnerable to suicidal thoughts and need our support, we were told. That support cannot be fully effective unless one affirms “gay identity,” which of course requires Christianity to “evolve.” As this strategy moves forward, we reach the point at which, if you are not in favor of gay marriage, you are condemned as a “hater” who is in favor of teen suicide.[9]

The reason why LGBTQ identity is so fragile and requires universal affirmation is because it is located in feelings that are in conflict with the order that God has inscribed in nature. The loving response is not to affirm such feelings but to help people align their lives with external reality, the way God our Creator has made us, while at once recognizing the ways in which sin distorts our perception of that reality. “For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well” (Ps. 139:13–14).


[1] Originally presented by Andy Wilson at the March 25, 2021 meeting of Granite State Reformed Ministers’ Fellowship

[2] See Rod Dreher, “The War on Religious Liberty,” The American Conservative (March 17, 2021), https://www.theamericanconservative.com/dreher/the-war-on-religious-liberty/

[3] Roger Kimball, “The ‘World’s Largest Bookstore Gets into the Censorship Business,” American Greatness (February 28, 2021), https://amgreatness.com/2021/02/27/the-worlds-largest-bookstore-gets-into-the-censorship-business/

[4] William Shakespeare, The Complete Works, eds. Stephen Orgel and A. R. Braunmuller (New York: Penguin, 2002), III.2.226.

[5] C. S. Lewis, The Abolition of Man (New York: Touchstone, 1996), 74.

[6] Ryan T. Anderson, “A New York Times Writer’s Reckless Hit Piece on My Transgender Book,” The Daily Signal (February 27, 2018), https://www.dailysignal.com/2018/02/27/new-york-times-writers-reckless-hit-piece-transgender-book/

[7] Chad Felix Greene, “How Ryan Anderson’s Banned Book, ‘When Harry Became Sally’ Helped Me with Gender Dysphoria,” The Federalist (March 1, 2021), https://thefederalist.com/2021/03/01/how-ryan-andersons-banned-book-when-harry-became-sally-helped-me-with-gender-dysphoria/

[8] Tim Pearce, “Amazon Bans Books Framing Transgenderism as ‘Mental Illness,’” The Daily Wire (March 12, 2021), https://www.dailywire.com/news/amazon-bans-books-framing-transgenderism-as-mental-illness

[9] R. R. Reno, “The Public Square,” First Things (April 2021): 65.

Andy Wilson is the pastor of Grace Presbyterian Church (OPC) in Laconia, New Hampshire. Ordained Servant Online, April 2022.

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Ordained Servant: April 2022

Responding to the Transgender Movement

Also in this issue

Commentary on the Form of Government of the Orthodox Presbyterian Church, Chapters 25–26

How the News and the Good News Shape Our Lives: A Review Article

The Making of C. S. Lewis by Harry Lee Poe

To Daffodils

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