Authenticity Over Evidence: When Belief Replaces Biology
Cori Cohn's talk from The Bigger Picture Conference
In the debate over trans medicine, evidence is no longer relevant
How can we convince school principals, board members, legislators, governors, friends, and family that it is crucial to protect children and young people? At Genspect’s conference in Albuquerque, Cori Cohn argued that we have passed the point at which evidence alone can make our case for us.
From a mental-health to an identity-based framework
In the 1980s, transsexualism was categorized as a pathology in the DSM-III. It was a psychiatric diagnosis, with interventions depending on assessment and evidence. The introduction of Gender Identity Disorder (DSM-IV) in the 1990s marked the first shift towards increasingly euphemistic ‘gender-affirming’ terminology. In the 2000s, this resulted in depathologization and increasingly relaxed eligibility criteria for medical interventions. By the 2010s, gender dysphoria (as defined in the DSM-V) had become normalized. Health insurance coverage had expanded, and a civil rights framework had been established to support personalized, affirming care (as set out in the WPATH Standards of Care, version 7). The slow change in language paved the way for a gender identity movement in the 2020s, where patients were empowered to demand aesthetic procedures as customers and get them on demand with no clear rationale for their provision. Services were increasingly organized around self-identified genders with informed-consent pathways (WPATH SoC-8).
“My new vagina will not make me happy”
Thus, the narrative has evolved from a paradigm based on mental illness to an informed consent model that no longer requires proof of efficacy or medical necessity. Personal autonomy and choice are now presented as human rights, with activists such as Andrea Long Chu arguing the ‘moral case for letting trans kids change their bodies’. The purpose of hormone treatments and surgery is not to obtain health or happiness - not even Long Chu’s own. The objective is not to treat a disease at all, but to achieve self-defined ‘embodiment goals’ (WPATH SoC-8) and to enable individuals to pursue their own highest or greatest truth. It’s a powerful narrative that asserts our privileged knowledge of our authentic selves and encourages us to “trust kids to know what gender they are”.
The counternarrative: Kids cannot change sex
Evidence no longer matters. And critics will not win the argument by citing systematic studies, no matter how excellent they may be. We need counternarratives.
Cori Cohn tried living as a transwoman for a number of years until he realized in 2010 that he could never become a woman: “I had to give up. I tried. I just had to realize it’s not possible for me, it’s not possible for anyone”.
The counternarrative he suggests is that “kids cannot change sex”. That authenticity is achieved by “living life, by having struggles, by making mistakes, and figuring out how to make amends, and recovering from the problems that you face in life. True authenticity is “revealed by living life, not by having an epiphany after watching TikTok videos”.
Cori Cohn is a writer, podcaster, and patient advocate from Indiana. Having transitioned as a teenager, he brings a unique firsthand perspective to the gender discourse.
I think that we might not be able to convince everybody to cease trying to change their sex. The sex change movement has persisted for a few generations already, and the number of people making these attempts is increasing, not decreasing. The rate of regret is reportedly lower than the rate of satisfaction, and the rates of short and long term complications have not yet emerged or been publicized to the extent necessary to deter people. As the surgeries and other cosmetic technologies continue to improve, it seems likely that rates of regret as well as the complications could fall even further.