The use of biology to defend "two sexes" completely negates the gender diversity in nature.
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On day one of his second presidency, Donald J. Trump signed the executive order "Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government." It reads like a page from George Orwell's 1984. It boils down to the federal erasure of a group I consider "my people." Beyond that, it represents an astonishing denial of scientific and medical evidence that refutes the antiquated belief that we humans exist only within the confines of a male-female dichotomy set in stone at birth.
Reading the executive order brought me back to my childhood, when, as a transgender, mixed-race American growing up in Kuwait, I truly felt that I had fallen from the stars into the desert landscape around me. It was the 1980s, and little was taught about biological sex and no mention of gender diversity. It wasn't until I discovered Dr. Joan Roughgarden's landmark work on gender diversity that I finally grasped the cold, hard evidence in my hands.
Gender and sex non-conformity are everywhere in nature if one cares to look.
By then, I was a young doctor undergoing my own gender transition. It was 2004. I spent the next two decades in the closet but never forgot that book.
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In the words of Dr. Roughgarden, "Hermaphrodism is a successful way of life for many species; my guess is that hermaphrodism is more common in the world than species who maintain separate sexes in separate bodies." The "biological truth," as meticulously documented by Dr. Roughgarden, is that among animals, plants, and humans, there have always been exceptions to the "immutable" male-female dichotomy our government would impose on us.
But don't mistake these assertions as a failure to face the facts. After twenty-five years in pediatrics and fourteen years as a parent, I know that all one needs to do is go to a playground or newborn nursery to see that we humans tend to fall into male and female categories. However, the dominant pattern is never the whole story. There is diversity in the newborn nursery, as much as anywhere in nature. Among "males" and "females," there are different shapes and sizes of genitalia and different so-called "anomalies" that blur the lines of biological sex.
Human diversity extends far beyond the physical. Which brings me to ideology. What is behind the federal government's reductionist ideology? The executive order makes much of the terms "gender ideology" and "gender identity," both being considered subjective assessments that "do not provide a meaningful basis for identification."
When was the last time a federal official looked in your pants to determine if, in their opinion, your gender identity matched your genitals? Today, identification is far more likely to be confirmed via facial recognition than anything to do with sex or gender. The premise that gender ideology and gender identity present insurmountable barriers to a person's identification is a ruse, perpetuating the tedious stereotype that gender non-conforming people are somehow morally suspect. It's easy to get distracted by such slander. Instead, let us consider the implications, many of which are already evident.
In just the first week after the executive order on "gender ideology" and "biological truth,' the government ordered federal workers to remove gender identity from email signatures. It banned the use of gender in any form, reinforcing their recognition of two sexes. All-gender bathrooms are being closed. At the Centers for Disease Control, the "Youth Risk Behavior Surveillance System" (YRBSS) website, an essential repository of information collected on risk behaviors of LGBTQ and other youth, disappeared. Portions of it have since reappeared, but it remains to be seen whether the risk behaviors of transgender youth will be tracked going forward. An alarming possibility, given that in 2022, the National Institutes of Health reported that "82% of transgender individuals have considered killing themselves and 40% have attempted suicide, with suicidality highest among transgender youth."
Statements supporting gender-affirming care, such as those by the American Medical Association and the American Academy of Pediatrics, carry no weight, even if they are still posted. This utter disregard for professional opinion opens the door further to the rejection of science, whether it's climate change, evolution, or vaccinations. It leaves us all vulnerable, as it did during the Covid-19 pandemic.
In terms of people's day-to-day lives, this onslaught of attacks will play out in large and small ways. In bullying, in suicide. In people never reaching their full potential, in families torn apart, in Americans denied health care. Some transgender people will choose to "go stealth." But for many, that's not an option, and lest you think that the drama of a minority of Americans is just that, consider that we are not alone in being targeted. After the personal retributions, after the trans smear, after the immigrant purge, after DEI, we might ask ourselves, who will be next?
And who will be left?
To my fellow transgender Americans, especially the young, I say, fear not. Know that you are not alone. Know that you are a part of the natural world and that you are trans, whether you can access gender-affirming care or not. We are a people with a long history. The times are dark, and the implications are real, but we have been here before.
In fact, we have been and will remain everywhere.
S.A. Mireles is an Associate Clinical Professor in the division of Pediatric Anesthesiology at Stanford University Medical Center. He is a proud transgender American and a provider of gender-affirming care at Lucile Packard Children's Hospital Stanford. The opinions expressed in this article are his alone.
Voices is dedicated to featuring a wide range of inspiring personal stories and impactful opinions from the LGBTQ+ and Allied community. Visit Advocate.com/submit to learn more about submission guidelines. We welcome your thoughts and feedback on any of our stories. Email us at voices@equalpride.com. Views expressed in Voices stories are those of the guest writers, columnists and editors, and do not directly represent the views of The Advocate or our parent company, equalpride.
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