What The Lancet gets wrong about women Why has the science journal waded into the gender ideology debate?

Not even, “people with vaginas”, though that would have been bad enough. The Lancet has now gone beyond the appalling language — “people who menstruate” — that so upset JK Rowling last year.

The excerpt came from a review of an exhibition on the history of menstruation by Sophia Davis, but my complaint is not with her — she used the words woman and women five times in her piece. My concern is that this specific quote was chosen to be used so provocatively on the cover.

The Lancet — one of the world’s oldest and best-known medical journals — is on a mission. The publication might claim that “improving lives is the only end goal,” but editor Richard Horton has grand plans. His vision, which he laid out in 2016 is political revolution.

“The idea of the Lancet was born at an extraordinary moment in the history of the world in the early 19^th century which was a moment of political revolution and social revolt. We have to capture that idea every single day in what we do… What I think we’re trying to achieve now is to capture that original idea – the essence of who we are, our identity, in these campaigns that we are developing.”

This journal is of course no stranger to controversy. In 1998, it published Andrew Wakefield’s now notorious article that linked the MMR vaccine with chronic enterocolitis and autism. By the time that paper was retracted — 12 years later — children had been harmed. According to Public Health England, “It had an important impact on MMR coverage which dropped to about 80% nationally in the late nineties and early 2000s and took many years to recover. … Measles cases continued to rise and in 2006 endemic transmission became re-established in the UK.”

Horton has strayed over the line from medicine into politics repeatedly, covering for example the invasion of Iraq and the conflict in Gaza. While he has been quick to challenge the UK government over the response to Covid-19, he has been rather more forgiving of the Chinese authorities.

It is perhaps no wonder that he has waded into one of the most charged political debates of our time: the material reality of flesh and blood. Yes, some people struggle with their bodies — for any number of reasons, but we can never be divorced from them.

The egregious quote might lead us to think that Horton believes otherwise. Does he really think that “bodies with vaginas” are as peripheral to humanity as, say, cars with a hatchback: mere perambulating devices that transport our metaphysical essence from place to place?

If so, he would be replacing modern science with Gnosticism, a heresy that stretches back much further than the founding of The Lancet in 1823. So ancient in fact, that it was first refuted by Ignatius of Antioch who died around 110 CE.

In the early second century, Gnostics separated the spiritual from the material. They held that matter was evil and the spirit good. Their focus was on the person of Jesus Christ — claims were made that he did not have a real body but only an apparent or phantom one — and a hope of salvation that came through esoteric knowledge, or gnosis.

There are strong parallels today in the debate over sex and gender. Adherents of what has become known as “gender ideology” might replace spirit with mind, but the schism between mind and body is much the same. Their entire belief system is constructed on esoteric knowledge.  Even small children are understood to be able to discern their gender identity, a mysterious quality that supposedly trumps mere biology when demarcating men from women.

As Mary Harrington suggested in her recent essay about latter-day “luxury Gnosticism”, when we can spend so much time in cyberspace in whatever form we please, it is seductive to believe that choosing our sex in the real world is as easy as toggling a switch and changing our name.

Gender ideology might not be a religion in the traditional sense but it is certainly a belief system. Gender identity — its principal dogma — is unprovable and unfalsifiable, yet we are expected to believe in it or keep quiet. It has its catechisms — Transwomen are women, transmen are men and non-binary people are valid — and its priestly class. They would be transgender people like me, supposedly with esoteric knowledge about what it means to be trans.

The reality — and I chose that word deliberately — is rather different, of course. Nobody, not even transgender people, can discern what it feels like to be someone else. All we have is our own experience. Are transwomen women, or are we men? Not only that, but men with a psychological disorder that drives us to want to become women? In a battle of ideas divorced from objective reality it is one person’s word against another.

That benefits nobody, not least transgender people who have been plunged into possibly the most toxic and divisive debate in politics. Campaigns that were once important — for example the resourcing of NHS gender services and the protection against less favourable treatment at work — have been overshadowed by pointless squabbles over pronouns.

Words matter, because if we change the words we use we change the way we think. In many contexts, sex has been replaced with gender and — equally troubling to me — transsexual has been replaced with transgender. In both cases, people are separated from their reproductive biology. That doesn’t help anyone live their life in the real world where sex does matter.

Horton’s chosen quote — bodies with vaginas — both extends and focusses the denial of humans as material beings. Not only does he separate people from their entire biology, he directs the attention at just one sex: women. The Lancet used very different language in a Tweet about men’s health last week, “About 10 million men are currently living with a diagnosis of prostate cancer.”

The complaints appear to be piling up at The Lancet, including objections from the medical profession itself. Professor Dave Curtus, a contributor to The Lancet, tweeted: “Just wrote the Lancet to tell them to take me off their list of statistical reviewers and cancel my subscription and never contact me about anything ever again. Absolutely inexcusable language to refer to women and girls.”

The concerns are far more than mere intellectual or academic protests. This type of language makes women yet more vulnerable. The ideologues might convince themselves that womanhood is somehow separate to femaleness but as Professor Selina Todd explained in The Post last week, “Ignoring sex doesn’t make sex-based discrimination and harassment go away, it just prevents you from dealing with it.”

Bev Jackson, founding member of the Gay Liberation Front in 1970 and more recently a co-founder of the LGB Alliance, went further in her analysis, “Dehumanization is the prelude to violence.”

Moreover, as in the MMR debacle over 20 years ago it is children who are being put at risk of harm. They have no special knowledge about their gender identity — nobody does — but promises are being made to them that can never be delivered: that they can somehow choose to be a boy or a girl. The flip side of course is the implied threat that if they choose incorrectly, they may go through the “wrong” puberty and never find satisfaction in life.

Now this quasi-religious belief system is being given legitimacy on the front cover of The Lancet. It took the journal 12 years to retract the misinformation over the MMR vaccine. For the sake of the current generation of young people, Horton needs to rectify this current outrage somewhat more quickly.

Gnosticism may be alluring but it is ultimately futile. We are our bodies. It is high time that politicians, policy makers, and even the editor of The Lancet accepts the truth that Ignatius knew by the turn of the second century.

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Debbie Hayton is a teacher and a transgender campaigner.

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