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John Oliver Gets Gender Wrong
Oliver uncritically parroted activist talking points on ‘gender-affirming care.’
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Earlier this week, John Oliver—famous for making both comedy and news out of complex, esoteric subjects (he once transformed credit scores into the stuff of laughs and outrage)—aired a 26-minute segment on trans rights. He covered “trans girls” in girls’ sports and pediatric “gender-affirming” care, among other issues. Perhaps he was feeling competitive with his old boss Jon Stewart, who aired a similar gender misinformation session on his own show the week before, and was thus racing to promote as many activist talking points as possible to preserve his liberal bona fides. This would at least partially explain why a rigorous fact checking process was seemingly thrown to the wind.
Given Oliver’s massive audience, one may have hoped he would have approached this topic with the seriousness and nuance it deserves. Unfortunately, that didn’t happen. Instead, Oliver ended up greatly contributing to the spread of harmful disinformation surrounding “gender affirming care” by uncritically repeating several common and easily disprovable falsehoods.
So let me fact-check, and add some nuance to some of what he said.
Oliver notes that the biggest and most dangerous area of disinformation surrounds the concept of gender-affirming care. There I agree with him, but, as painful as it is for a liberal like me to admit—and as much as it sounds like conspiracy theory—the medical associations and mainstream and liberal media are the ones spreading that misinformation, not the Right. But, as I’ll explain later, the Right isn’t doing the right thing with the correct information, either.
During his segment, Oliver refers several times to the young trans activist Kai Shappley, who seems, he says, so happy after being allowed to live as a girl. Oliver must be unfamiliar with the research showing that the vast majority of children like Kai, if not socially transitioned, desist in their transgender identity by the end of puberty and grow up to be gay. And he must also be unfamiliar with Kai’s own backstory. His Right-wing, Christian mother Kimberly wrote that “Family members were flat-out asking me if this kid was gay. It made me nervous, and I was constantly worried about what people would think of me, of us and of my parenting.” Kimberly was horrified at Kai’s gender nonconformity and wholly unaccepting of it and what it might portend about his sexuality. She wrote, “There were time-outs, so many time-outs. There were spankings and yelling matches and endless prayers. I even contacted the daycare Kai attended and asked them to put away every single ‘girl’ toy.”
Though the mother desperately didn't want a trans girl either, eventually both parent and child felt better once Kai was a girl and not a potentially proto-gay boy, but Oliver didn’t mention that social transition may greatly increase the likelihood of medicalization, and that hormones and surgeries do not always produce the happy endings that are widely portrayed, as evidenced by fellow “trans girl” Jazz Jennings’ botched genital surgeries. It’s not at all clear whether social transition is the right move for kids like Kai and Jazz. As a 2019 paper put it, social transition was “relatively unheard-of 10 years ago,” and “early-childhood social transitions are a contentious issue within the clinical, scientific, and broader public communities.” But Oliver didn’t mention the lack of consensus about how to treat kids with gender dysphoria and/or cross-sex identities, both psychologically and medically.
He calls rapid-onset gender dysphoria (ROGD) “total horseshit,” in part because the one study that found clusters of teen girls suddenly coming out as trans, by Lisa Littman, was conducted by interviewing parents recruited from “anti-trans” websites. This method, he says, is “instantly disqualifying,” though parental reports are a common way to gather information about children. Oliver then cites shoddy suicide stats, including a study claiming that 58 percent of adults who wanted hormones and didn’t get them reported suicidal thoughts. Lo and behold, that study was retrospective and recruited participants only from “pro-trans” sites, and therefore did not include anyone who got hormones and regretted it later or felt suicidal once on them. That study, too, was guilty of sampling bias. One published critique of the study noted “this finding came from a low-quality survey which is known to have elicited unreliable answers,” but this didn’t cause Oliver to refer to the original study as “total horseshit” or call for its instant disqualification.
What Oliver (and his writing staff) fails to understand is that ROGD was never meant to be a clinical diagnosis, but rather a way to distinguish a new and increasingly common cohort of teens, the likes of which had rarely been seen in the decades of research on gender dysphoria (known previously as gender identity disorder). The protocol for medically treating those then called “young transsexuals,” and now referred to as “trans kids,” is based on one small study out of the Netherlands. The young people in that study were screened for other mental health issues. They had consistent, insistent, and persistent gender dysphoria since early childhood, and lived in supportive families—and they were mostly boys (though my speculation is that there was a tomboy category for masculine girls, and parents were more likely to refer boys because they were disturbed by their feminine behavior).
However, this new cohort of mostly teen girls described in Littman’s research bears little resemblance to the cohort on which all prior research had been conducted. Their sudden appearance, spiking around 2015, alarmed health officials in countries like Finland and Sweden. Those countries conducted systematic reviews of the evidence, which resulted in them drastically altering their guidelines to urge caution and psychological support above medicalization.
Another reason those countries pulled back was the emergence of detransitioners, a phenomenon that Oliver describes as “rare and highly individualized” (whatever that means). He repeats outdated studies that suggest only 2 percent of those who transition end up detransitioning, and that some of them only do so because of external factors like stigma or access. But while the latter may be true in some cases, we are seeing many examples of young people deeply physically and psychologically harmed by gender medicine, and we have no idea what the detransition rate is. One small recent study showed that 6.9 percent of patients detransitioned after just a year, but noted that “Rates of detransitioning are unknown.” Unknown—not rare. And some believe that it may even take as long as 10 years for regret to set in. Considering the massive increase in patients in the last decade, it makes sense that we’re starting to hear from more detransitioners now. Why not listen to them, instead of insisting they don’t exist or shutting them down?
He then recites the tired line that puberty blockers are “reversible” and act like a “pause button” for puberty that can be seamlessly resumed. Talk to the kids with osteoporosis, maybe. As journalist Jesse Singal pointed out, the NHS deleted the claim that puberty blockers are “fully reversible” from its website and replaced it with a list of potential side-effects and an admission that “little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria.” We have very little data about their long-term effects on brain maturation, sexual health, and bone density, but we do know that women who went on them complained of “lasting health problems.”
Oliver stresses the difficulty in accessing care, that no one is getting surgeries willy-nilly, and that families are always included in the process. While it’s true that in some areas of the country it may be harder to find to a clinic that performs surgeries or prescribes cross-sex hormones and puberty blockers, this is not always the case. In fact, none of those statements are accurate according to the many parents and young people I and many other journalists have interviewed. He assures his audience that top surgery only happens after a team of medical professionals have discussed all the potential risks and benefits with patients and parents, that it’s a long process and incredibly expensive. But this ignores the many devastated adolescents and young adults who got their surgeries willy-nilly without being properly informed about the risks and benefits, and that Obama-era rules force insurance companies to cover the costs of such surgeries.
Amazingly, he does admit these interventions can cause infertility, but he doesn’t seem to think that’s a big deal.
The truth is, we don’t know much about the provision of gender-affirming care at all because there is no oversight, no long-term follow-ups, no data collection. One site that chronicled the explosive growth of gender clinics was removed by Google earlier this year—a move that smacks of gun lobbies trying to prevent data collection about firearms.
As for his reporting on sports, Oliver falls into the trap of calling bills that restrict girls’ sports to biological females “bans” on trans kids in sports, even though they can play in their own sex category. He asserts that there are “vanishingly few examples” of this happening, despite the fact that we have no data at all on how common or uncommon it is. He assumes a politician taking on the issue must be doing so because “literally every other problem has been solved.”
But I called up Kim Jones, co-founder of the Independent Council on Women’s Sports, who has been monitoring this growing phenomenon. Jones’ daughter lost to Lia Thomas, the UPenn trans woman who went on to win an NCAA women’s swimming championship title. Biological males competing in women’s categories, “is far more common than people realize,” she told me, sending me examples in cycling, rugby, softball, soccer, surfing, skateboarding, skiing, rowing, golf, snooker, track, weightlifting, archery, tennis, swimming, ultimate Frisbee, disc golf, and volleyball. Oliver failed to mention that a girls’ volleyball team in Vermont is prohibited from using the locker room after objecting to a trans girl—a biological male—changing with them there because they were uncomfortable (some news sources say that all kids are prohibited from the locker room and the trans girl was bullied herself). Why not paint that objection as reasonable and explore solutions instead of ignoring their plaints?
To defend biological males in women’s sports, Oliver trots out the assertion that no one transitions to win a sport, but I don’t think that’s the real issue. It’s about fairness, says Jones. “The way men have their sports protected for fairness is they have doping rules,” she said. “The way you achieve inclusion in sport for women is by having a women’s protected category.” As soon as males compete in the women’s category, she said, “you exclude women.” Inclusion and fairness are in conflict, and Oliver should explore that conflict rather than side against women.
Oliver laments that the state is intervening in these issues, and I agree—I wish medical associations and schools would stop being so paralyzed and create sound, fair, and evidence-based policies. Instead, Republicans have passed policies and laws to criminalize parents and doctors who perform gender medical interventions on children—or pediatric and adolescent sex changes—as well as sending CPS to investigate those families, and they shouldn’t have to. Our medical institutions should look at how other countries are changing their guidelines after reviewing the evidence, examining the surge in gender dysphoria diagnoses, and listening to detransitoners. Meanwhile, the threats of violence against children’s hospitals, while fortunately still just threats, are unconscionable and contribute greatly to the politicization of pediatric gender medicine. This will not help give children the care they need and deserve.
The Democrats, on the other hand, have passed laws that allow children to medically transition without parental consent, sent CPS after parents who don’t socially or medically affirm their trans-identified kids, and attempted to criminalize parents who refuse pediatric gender medical interventions. I think it’s safe to call these actions on both sides “fucking insane,” which is a term Oliver uses several times, but never for the Democrats.
Credit where credit is due, Oliver acknowledged early on that some people on the left do have objections to, say, some of what is being taught about gender in school, or the presence of young males on girls’ sports teams. He accused us of being “reluctant to engage on this issue” or “outright hostile to it, either complaining about pronoun police or arguing that this issue will cost Democrats elections.” It’s weird to me that such assertions are swept away as wrongthink, because, well, yeah, a lot of people on the Left are worried about the compelled speech of pronoun announcements and that the Left’s handling of this issue may cost us the election and, with it, our democracy. Why not take that seriously?
“None of this makes any sense,” Oliver announces—and that much is true. Kids shouldn’t need to be activists, he says. They should be able to dress how they want and play the sports they want to play. I agree. And they can. They just may have to abide by some rules that ensure fairness, and we may have to consider the competing needs of different groups.
That should never be misconstrued as hate.
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