08 July 2020

When is a "TERF" not a TERF?

In the responses to JK Rowling’s challenge to the more extremist (and vocal) factions of transgender activists, there has been much more name-calling than reasoning.  The most common such epithet has been to call her (or anyone else) a TERF, a “trans-exclusionary radical feminist.” 

Having been deeply involved in the science and clinical care of trans people for more than two decades, I have watched this particular term evolve and lose whatever meaning it originally had.  It used to refer to the most extreme of the other side:  There do indeed exist genuinely transphobic people who will refuse to recognize anyone’s transition under any circumstances and are accurately called TERF’s.  Now just a social media meme however, the term is bandied so broadly that it no longer carries any meaning at all.

I must first challenge the ironically binary premise that “exclusion” is all or none.  It’s only in the current climate of extremism that no moderate views get discussed.  Here is a range of some areas in which sex/gender require protection:

• Employment
• Housing
• Public accommodation…
• Locker rooms/showers, with nudity (sauna, hottub…)
• Locker rooms/washrooms, sex segregated
• Competitive sports teams, where physical size is an advantage

It would be perfectly accurate to call someone “trans exclusionary” for rejecting transpeople from all of these.  But that’s not meaningfully the same as (for example) a cis-woman who supports all civil rights, but feels uncomfortable naked in a locker room with a person whose every external feature is male (i.e., their female features are all internal).  I’m not saying I *agree* with this hypothetical cis-woman—I am pointing out the error of painting this entire range of opinions with a single dichotomous brush and dismissing them all as if they were all the most extreme imaginable.

Also on a spectrum is the point during transition at which one can/may/should be deemed which sex:

• Upon declaration
• Upon psych/medical exam/approval
• Upon declaration *despite* psych/medical exam results
• Upon part-time social living
• Upon full-time social living
• Upon hormone treatment
• Upon genital surgery
• Never

It’s easy to recognize “never” as genuinely transphobic/exclusionary.  But it is not meaningful to use the same term for everyone who breaks from the opposite extreme, based only on a recent (sometimes even curiously convenient) self-declaration.

Relatedly, there also exists debate over the age at which a youth should be permitted to begin to transition, socially and/or medically:

• Prepuberty (upon request/demand from child)
• Age 12 (mid-puberty, breaking point in outcomes research)
• Age 16 (usual age of consent for sex)
• Age 18 (legal age of adulthood)
• Age 25 (final brain maturation)
• Never

I support age 12, not for any ideological reason, but because that is what the (current) evidence supports:  The majority of prepubescent kids cease to feel trans during puberty, but the majority of kids who continue to feel trans after puberty rarely cease.  To someone who supports “upon demand,” however, everyone everywhere else on the spectrum is the same as the farthest opposite extreme.  It is not meaningful to claim that wait-until-12 is the same as never.

To repeat, I am not actually taking sides on any of these issues (except to indicate what is vs. not consistent with the science).  Rather, I am pointing out that “TERF” does not meaningfully convey anyone’s ideas about anything.  It is being used only as an epithet, to discredit rather than inform, holding even the slightest symbolic evidence of the smallest departure from one extreme as proof of membership of the other extreme....It is being used as an excuse not to engage with what the person is *actually* saying.


  1. Women in the USA lost their right to their prescribed contraception without the approval of her employer today, 7/7/20. I posted this online. A trans responded "contraception has nothing to do with being a woman".
    Gender does not equal sex. Feminine does not define female. Trans does not define me. I am a woman. Transgender is a psych disorder.

  2. Excellent points that highlight the type of discussion we "should" be having in society with respect to trans rights. The extremist position that's been staked out is entirely policy capture without any attempt to balance different perspectives or concerns. The biggest risk is that the public loses trust in government, the media and the law as people slowly wake up to this "new reality" being imposed on us. What then?

  3. Terrific and balanced analysis, yet it fails to mention the "elephant in the room"--the fact that probably 90% or more of the cases that the debate is about are NOT childhood-onset gender dysphoria that persisted into adolescence.

    As you undoubtedly know, today, today the predominant GD presentation is ROGD, where the young people (primarily female) become dysphoric about their sexed body for the first time in adolescence. For many it happens right around 11-12, and they are gleefully transitioned with hormones by healthcare professional citing the evidence referenced above, and ignoring that 100% of the Dutch study's subjects had classic, childhood-onset GD that persisted into adolescence. This fact is so central to the debate of what appropriate care for young GD should look like, that it's omission, along with the endorsement of 12 as the appropriate age for hormonal interventions, will likely play right into the hands of those who support biomedical interventions on youth as the first line of treatment. After all, nobody, not even the most committed proponents of hormonal interventions for youth, would suggest hormones for those <11-12.

  4. "Also on a spectrum is the point during transition at which one can/may/should be deemed which sex"

    The answer to that is never. Homo Sapiens cannot change sex. To think that they can is disingenuous at best and delusional at worst.

  5. James,
    I've appreciated reading your thoughtful and informed commentary. When you say:

    Also on a spectrum is the point during transition at which one can/may/should be deemed which sex:
    It’s easy to recognize “never” as genuinely transphobic/exclusionary.

    I am not sure what you mean by "genuinely". I understand what sex is, having in education in biology and chemistry . I know how complex cells are and I know that "never" is *entirely* correct. There is no plausible way a person can change their general potential to produce the opposite type of gametes since that's tied to a great deal of molecular machinery. We are each a unique bag of molecules, but those molecules come in clear types (proteins, nucleic acids, lipids, carbohydrates etc.). Different arrangements of those molecules demarcate different cell types (brain cells, ova, sperm), clusters of which can be classified into different tissue types and ultimately organs. "sex" is just another one of those sorts of clear types. The borderline cases in any of those types don't invalidate any of the types themselves.

    I know better than to think that someone who has undergone superficial surgery or hormone injection is *actually* the opposite sex. No examination of cell types in tissue etc. would pass scrutiny. Such an adult would never be enrolled as the opposite in a clinical trial. Adults have considerable liberty in doing what they want to do to their bodies, I have serious doubts about the effectiveness of SRS-related interventions but I (and I think most people) are not interested in standing in the way of an adult making a decision for something that is available to them. I have no intention of treating anyone uncivilly because they elect such interventions, but I can't just turn off my brain and "deem" them to be of the opposite sex. You seem to be asking me to do that in your writing and that's quite dubious.

    Genetic males/phenotypic females etc. certainly do deserve the ability to self declare sex given most people don't understand enough about molecular biology to understand those conditions. There are such few individuals easily certified, and I've never met anyone that is interested in telling them to do anything other than what they think is good for them.

  6. I think the key word there is "deemed" - perhaps as with the concept of "legal fiction", or "treated as". There are cases where a person who is male in the sense of having proceeded some way down the developmental pathway for producing small gametes is rightly treated socially as a woman and it would be transphobic or some sort of meanness to refuse.

    1. If we presume the contexts already listed in the post (under "require protection") and other obvious ones (medical treatment, clinical trials etc.)...what does it mean to "rightly" treat someone as a woman?

  7. Honestly, a lot of casual onlookers to the trans debate ought to be shown this article, whichever "side" they feel inclined to take. It's such a simple and straightforward summary of how complex the debate actually is.

  8. It's probably no coincidence that the sex drive usually kicks in around age 12.