Arts & Culture Literature

Author: Sex reassignment procedures do not change people’s sex, they merely masculinize or feminize outward appearance

Ryan T. Anderson, Ph.D.

Ryan T. Anderson Ph.D. is the author of “When Harry Became Sally: Responding to the Transgender Moment”.  He is also the William E. Simon Senior Research Fellow in American Principles and Public Policy at The Heritage Foundation, where he researches and writes about marriage, bioethics, religious liberty and political philosophy.

In much of his writing, he makes an argument against giving children, of an age where they could not legally decide to drink alcohol, the right to decide to alter their bodies in preparation for “sex reassignment” surgery.

As he does in his book, in an article, published in The Daily Signal,  Dr. Anderson claims there is a ‘danger’ in assuming gender can be reassigned and supporting children’s beliefs that they should be reassigned.

Referring to a case last week, where parents in Ohio lost custody of their 17-year-old daughter because a judge ruled ‘she’ should be allowed to receive testosterone therapy to identify as a boy, Dr. Anderson writes, “Americans can expect to see more cases like it as government officials side with transgender activists to promote a radical view of the human person and endorse entirely experimental medical procedures. At stake are not only parental rights, but the wellbeing of children who suffer from gender dysphoria.”

According to the American Psychiatric Association,Gender dysphoria involves a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify.”

Transgender activists claim that sex isn’t necessarily “assigned” at birth—and can be “reassigned.”

Transgender activists maintain that, when a child identifies as the opposite sex in a manner that is ‘consistent, persistent, and insistent,’ the appropriate response is to support that identification.

According to Dr. Anderson, the transgender activists support a four-part protocol:

  1. Social transition: Giving the child a new wardrobe, a new name, new pronouns, and treating the child as if he or she were the opposite sex.
  2. Placing a child approaching puberty on puberty blockers to prevent normal maturation and development. “This means there will be no progression of the pubertal stage, and a regression of sex characteristics that have already developed,” Dr. Anderson writes.
  3.  At around age 16, cross-sex hormones are given to the child to mimic the process of puberty that would occur in the opposite sex. The children  can expect to be prescribed cross-sex hormones throughout their adult lives.
    1. Boys are given feminizing hormones [estrogen] to develop breasts and the body shape of a female.
    2. Girls are given masculinizing hormones such as androgens (testosterone) for a low voice, facial and body hair growth, and a masculine body shape. It also causes an enlargement of the clitoris and atrophying of the breast tissue.
  4.  At age 18, the individual may undergo sex-reassignment surgery: amputation of primary and secondary sex characteristics and plastic surgery to create new sex characteristics.
    1. Female-to-male surgery can include mastectomy. The uterus and ovaries are often removed. Some patients undergo a surgically constructed penis.
    2. Male-to-female surgery involves removing the testes and constructing “female-looking external genitals.” Estrogen therapy generally  produces satisfactory growth of breasts.


Dr. Anderson writes, “[B]locking puberty with drugs …  turns things upside down, for virtually every part of the body undergoes significant development in sex-specific ways during puberty, and going through the process at age 18 can’t reverse 10 years of blocking it. The use of puberty-blocking drugs to treat children with gender dysphoria is entirely experimental, as there are no long-term studies on the consequences of interfering with biological development.”

Dr. Anderson quotes three American physicians/researchers, Drs. Paul Hruz, Lawrence Mayer, and Paul McHugh who note, “one would expect that the development of natural sex characteristics might contribute to the natural consolidation of one’s gender identity.”

Dr. Anderson believes that most children will naturally grow out of any gender-identity conflicted stage. But puberty blockers will reinforce their cross-gender identification, “making them more committed to taking further steps in sex reassignment.”

“The rush of sex hormones and the bodily development that happens during puberty may be the very things that help an adolescent come to identify with his or her biological sex,” Dr. Anderson writes. “Puberty blockers interfere with this process.”

Dr. Anderson argues that “sex is a bodily reality…  The sex of an organism is defined and identified by its organization for sexual reproduction. Modern science shows that this organization begins with our DNA and development in the womb, and that sex differences manifest themselves in many bodily systems and organs, all the way down to the molecular level.

“Secondary differences between the two sexes—attributes that may be visibly altered by hormone treatment and surgery—are not what make us male or female. As a result, cosmetic surgery and cross-sex hormones don’t change the deeper biological reality. People who undergo sex reassignment procedures do not become the opposite sex, they merely masculinize or feminize their outward appearance.”

Rather than putting children on a process of ‘social transitioning’ followed by puberty-blocking drugs, Dr. Anderson writes, “A more cautious therapeutic approach begins by acknowledging that the vast majority of children with gender dysphoria will grow out of it naturally. An effective therapy looks into the reasons for the child’s mistaken beliefs about gender, and addresses the problems that the child believes will be solved if the body is altered.”

“When Harry Became Sally,  relates how mental health professionals liken gender dysphoria to other dysphorias, or serious discomfort with one’s body, such as anorexia, body dysmorphic disorder, and body integrity identity disorder. All of these involve false assumptions or feelings that solidify into mistaken beliefs about the self.

“Much like patients with anorexia nervosa, these children mistakenly believe that a drastic change of their bodies will solve or minimize their psychosocial problems,” Dr. Anderson writes. “But adjusting the body through hormones and surgery doesn’t fix the real problem, any more than liposuction cures anorexia nervosa.”


Dr. Anderson points to Drs. McHugh, Hruz, and Mayer who emphasize. “Normally, a child is not encouraged to persist in a belief that is discordant with reality. A traditional form of treatment for gender dysphoria would ‘work with and not against the facts of science and the predictable rhythms of children’s psycho-sexual development’.

The book also analyzes education and employment policies, “Obama-era bathroom and locker-room mandates, politically correct speech codes and religious-freedom violations.”

Dr. Anderson argues that law is “being used to coerce and penalize those who believe the truth about human nature.”

He claims Americans “can begin to push back with principle and prudence, compassion and grace.”


To learn more or buy Dr. Anderson’s book 


About the author

Frank Parlato


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