December 3, 2023 - 8:00am

A recent New York Times op-ed entitled “There is no way to live a life without regret” meditates on youth gender transition, regret and how we know who we are (I’ll save you a few thousand words: we don’t). 

As far as op-eds go, it’s poorly argued and far too long. But as an example of its genre —a genre we could call ‘Desperately Throwing Spaghetti at the Wall’ — it’s unbeatable. 

“[L]iberals and progressives who fret about the rapidly changing gender landscape,” according to author Lydia Polgreen, are too worked up about the possibility that children and adolescents may later regret the decision to transition. Rather than address their actual concerns, however, Polgreen gives readers a rambling tour of misdirections: gender is like race, somehow, and also like an arranged marriage. Further, life is full of “transitions” that are like “little deaths,” all leading up to the biggest “transition” of all: the big sleep. 

Some teenagers get nose jobs and boob jobs, so why should gender transition surgery be viewed as any different? “Cosmetic procedures can produce regret, sometimes famously so,” the author writes. Never mind that few of youth gender transitions’ critics champion cosmetic surgery for teens. The point is, “gender-affirming” care has not been billed to regulators, consumers, and the public as cosmetic, but held up as life-saving procedures, covered under many public and private health insurance plans, and carried out in the name of medicine as a treatment for distress. The stakes matter. 

But what is a life without regret? This is a talking point that started circulating relatively recently, in response to mounting evidence of regret and detransition, and concerns that social influence may be driving the explosion in gender-distressed youth — the way just about everybody acknowledges that social influence drives the recent surge in TikTok tics or multiple personalities. So what if it’s a social contagion? “What is gender if not contagious?” Polgreen asks. 

Because few young people who embarked on transition as children have spoken up, the author first dismisses their experiences as rare and overhyped (“a handful of such people have appeared over and over again in news stories across the world”) before writing them off altogether a few paragraphs later (“when the media fixates on the hypothetical regret of children who do transition…”). 

Besides, maybe deciding to transition as a child is like quitting the swim team: “so what are we saying, really, when we worry that a child will regret this particular decision, the decision to transition? And how is it different, really, from the decision I made to quit competitive swimming?” 

Of course, a child who quits competitive swimming merely forecloses a competitive swimming career. One needn’t give up the ocean or the pool whereas children who undergo puberty suppression, cross-sex hormones, and surgeries foreclose more than one possible future. Fertility, sexual pleasure, the possibility of growing up and becoming comfortable in one’s own intact body, to name a few.

We have no idea what childish decisions like these will mean 50 years down the road. And again: Polgreen has pulled the conversation off-course to avoid the inconvenient topic of medical responsibility. The decision to quit swimming is not a medical decision, cosigned by medical authorities. Youth gender transition is. 

The author goes on to make a number of bizarre analogies in this 4,500-word slog. But she never touches the real arguments that she pretends to counter: that children are not just small adults, that the medical system needs to be accountable for the power it exercises, and that children who struggle with gender distress need real support, not empty meditations on identity, autonomy, and the ubiquity of regret.

Polgreen misdirects and obfuscates in a half-dozen creative ways, then reifies her misdirections. She misses the point — on purpose — and then wonders why so many people care so much about this issue.

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