March 11, 2024 - 7:00pm

Sex changes ought to be a universal human right, the author and critic Andrea Long Chu has argued.

In a new piece for New York magazine, Chu, who is transgender, writes that all people, including children and those with mental illness, should be able to medically alter their sex at will.

“We will never be able to defend the rights of transgender kids until we understand them purely on their own terms: as full members of society who would like to change their sex,” the writer notes. “It does not matter where this desire comes from […] We must be prepared to defend the idea that, in principle, everyone should have access to sex-changing medical care, regardless of age, gender identity, social environment, or psychiatric history.”

Chu goes on to state that puberty blockers and cross-sex hormones have also been used to treat infertility and menopause, preserving patients’ natal sex against the process of ageing. Transgender people should therefore have just as much of a right to these drugs as patients using them to affirm their birth sex.

“What we today call gender-affirming care is part of a larger history of sex-affirming care governed by strong normative ideas of health, productivity, and moral worth,” Chu writes. “The real question is which sex can be affirmed — and why […] It is the purpose of sex change, and not the change itself, which determines its acceptability.”

Chu has written essays on gender for an array of prestige publications including the New York Times, and was awarded a Pulitzer Prize last year for book reviews. The writer is perhaps best known for an essay titled, “My new vagina won’t make me happy”, which argued that mental wellbeing wasn’t the point of transitioning.

The writer has a reputation for subversion even within trans circles, previously making the taboo argument that porn and sexual desire can be driving factors in transgender identification. This breaks with the belief popular among activists that transitioning is strictly a means of self-actualisation rather than fetish fulfilment.

Proponents of transgender treatments respond to fears about child transitions by claiming that minors typically don’t undergo cross-sex genital surgery. In addition, they argue that the treatments minors do undergo are generally reversible, and that there are firm guardrails in place preventing children from undergoing said procedures due to a sudden change in gender identity or psychiatric problems. Chu, conversely, argues that the practice “should be happening”. “What does this freedom look like in practice?,” the writer asks. “Let anyone change their sex. Let anyone change their gender. Let anyone change their sex again.”

The writer also breaks with gender critical feminists, repeatedly mocking and dismissing women’s fears of sexual assault at the hands of trans-identified males: gender-critical feminists’ fear of rape is a “paranoid fantasy”, and that trans women are more likely to be sexually assaulted than biological women.

“What we are witnessing is a potential reconfiguration of the division of sex — one that is highly disturbing to anyone with an instinctive loyalty to the status quo but that is no more inherently revolutionary than, say, the contraceptive Pill,” Chu writes. “Sex-affirming care has always served someone’s moral vision for society. There is no reason it cannot serve ours.”


is UnHerd’s US correspondent.