This week in New York magazine, Chu sets about dismantling what little respectability the trans movement has been able to defend against its own radical fringe. Forget doctors and parents! Screw caution! Don’t protect the kids! Down with expertise and common sense! Up against mounting evidence of medical harm and growing caution from the general public, Chu lays the case for child medical transition shockingly bare: “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 appears to have received the same set of briefs as other trans activists: 1) Everything is “gender-affirming care” now, even your mother’s hair dye and your father’s Viagra. 2) “[I]f children are too young to consent to puberty blockers, then they are definitely too young to consent to puberty.” 3) Changing your mind is no big deal. Life is full of regret (so why bother listening to all those detransitioners?). Chu suggests, “Let anyone change their sex. Let anyone change their gender. Let anyone change their sex again.”

4) Redefine everything. Redefine keeping trans-identified boys out of girls’ sports as “patriarchal” and white supremacist (somehow). Redefine sex as changeable. Redefine reality as optional. 5) When all else fails, accuse your critics of defending their own fragile gender identities, as Chu does by suggesting that women such as J.K. Rowling “too might have transitioned given the chance, so intensely did they hate being teenage girls”.

But Chu’s too-clever arguments spill over into transparent lunacy. As performance art, it’s an interesting show; as political stance, though, it’s madness. After mocking — and yet not in fact dismantling a great many strawmxn, from rapid-onset gender dysphoria to the basic principles of medical ethics — Chu is ready to storm the barricades: “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. It does not matter where this desire comes from.”

Chu acknowledges critics’ concerns that children’s embrace of a transgender identity might be rooted in “depression, anxiety, autism, family dysfunction, peer pressure, or social media […] not to mention the universal awkwardness of puberty itself” — then declares that none of that matters. The desire to transition suffices even if, as in Chu’s case, the fulfillment of that desire may make one miserable.

The writer insists that “The real question is which sex can be affirmed — and why.” Thus medicine becomes a conspiracy wielded against trans-identified patients, “trans children” most of all. Why withhold from transmasculine teens the procedures doctors offer women with breast cancer (mastectomies)? The answer must not have anything to do with medical evaluation or ethics, only a bigoted miserliness with the instruments of self-transformation.

In Chu’s hands, “sex-affirming care” becomes a category so broad that it includes not just the regular entrants such as oestrogen replacement therapy for menopausal women but a host of atrocities: “vaginal surgeries tested on enslaved women in 1840s Alabama; the testicular transplants performed on gay men in Nazi Germany; and the surgical modification of infants with atypical genitalia.”

In a perverse way, this capaciousness is fitting. “Sex-affirming care” for Chu’s “trans kids” may turn out to be just the same kind of medical atrocity.

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Eliza Mondegreen is a graduate student in psychiatry and the author of Writing Behavior on Substack.

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