Near the end of their conversation on Beyond Gender, Alex Byrne and Moti Gorin arrive at the question their whole argument has been circling: we have created the category of the transgender child; we should recognize that we created it; and then we should ask whether we ought to keep doing so. It is the right question. I want to argue that the tools to answer it are already lying in their own account — and that they left the most important one idling.
Their framework is Ian Hacking’s Making Up People: some kinds of person do not exist until a society names them, builds institutions around them, and trains experts to spot them. Byrne and Gorin walk through Hacking’s menagerie — the nineteenth-century fugue patient who fell into fugue states because psychiatry had named the condition; the multiple-personality patient; the police officer, who plainly exists but did not before someone invented the role. Their claim is that the trans child belongs on the fugue side of the ledger: not discovered, but called into being by the classification itself. Byrne says it directly — these children are less like the quirky kids later relabeled “high-functioning autistic,” who existed all along, and more like the fugue cases, who did not.
That is a strong claim, and I think it is right. But notice what does the work in the fugue example. Not merely the name, but the feedback between the name and the person. Hacking had a term for that feedback — the looping effect — and it is the engine of the entire phenomenon. In this very conversation, Gorin grants it: there are looping effects, he says, only partly under our control. Yet in the paper, the mechanism is explicitly set aside as machinery they “do not use” because they were instead responding to a paper by Jilles Smids & Peter Vasterman, which put forward Hacking’s looping theory as a possible explanation for the sharply increasing number of adolescents seeking to medicalize their gender. The result is an account that describes the surge in trans-identifying children without quite explaining its motion.
The looping effect is what converts a static label into a self-expanding one. The category is defined; individuals recognize themselves in it and adjust — their self-understanding, their behavior, their sense of what they are; that adjustment feeds back and sharpens the category, which draws in more people, whose arrival is then cited as proof the kind was there all along. Description becomes prescription becomes population. Promote the loop from a footnote to the center of the story and their closing question nearly answers itself.
But there is a second variable they circle without naming, and it decides how fast the loop runs: the looseness of the central term.
Here their finest philosophical move does my work for me. Byrne and Gorin argue that you can believe trans people exist without believing anyone has a “gender identity” — just as you can believe bishops exist without believing in the Holy Spirit. Bishops are real; they simply are not what the faithful take them to be. Telepaths, by contrast, do not exist at all, because being purely fictional, there was never any real underlying phenomenon for the word to latch onto, only an alleged power. The trans adult, they conclude, is a bishop, not a telepath: a genuine social role wrapped in a mistaken theory about its own nature.
Follow that through. If the reality of the category never depended on “gender identity” in the first place — if “gender identity” is the Holy Spirit of the story, the mistaken theory rather than the thing itself — then bolting an entire clinical and social apparatus onto that inner, unfalsifiable “sense” is not a harmless metaphysical error. It is precisely what lets the loop run hot. A criterion that circular can absorb almost any child: the anxious, the autistic, the same-sex attracted, the merely gender-nonconforming. The vaguer the term, the wider the intake, the faster the category grows.
Contrast the blunter word the conversation keeps drifting back toward: transsexual, or plain sex. Its virtue is that it is tethered to bodies — to the anatomy that medical intervention actually acts upon, and to the outcomes that matter: fertility, desistance, the irreversible. It keeps the stakes in view. Trade it for an “internal sense,” and you have liberated no one; you have merely removed the brake.
Byrne makes a parallel point I can speak to from the inside. People with disorders of sex development, he notes, usually prefer their specific condition to the umbrella “intersex.” I am one of them. My own — hypogonadotropic hypogonadism — is an objective state: a measurable hormonal deficit with a standardized, evidence-based treatment, much as Swyer syndrome is a defined failure of the Y chromosome to switch on male development, with a known course and settled care. “Intersex” blurs unrelated conditions into one vague word, exactly as “gender identity” blurs unrelated children. The specific term clarifies; the umbrella obscures — and what I do with my own diagnosis is my business.
This is also the honest way to read their closing analogy. Being trans, they suggest, works like a symptom — a fever, not a diagnosis — that ought to prompt a search for the underlying cause rather than an endpoint of born this way. Just so. But a symptom-label stays useful only as long as it keeps pointing past itself to an etiology. “Gender identity,” as currently deployed, does the opposite: it terminates the inquiry. The handbook they cite, The Transgender Child, ends exactly where medicine should begin — some people are just born that way — and hands the child to the clinic.
So: should we keep creating trans kids? On the authors’ own premises, the answer falls out of the two variables they underplay. The category is self-reinforcing — the loop — and it is inflated by a term too vague to constrain it — the “internal sense.” Left running, that pairing does not locate a fixed population of children; it manufactures a growing one. The responsible move is not to deny that some children suffer — plainly some do — but to deflate the category that organizes their suffering: to slow the loop by returning to language anchored in sex, and to treat the distress as a symptom with causes rather than an identity with a destiny.
That is where the institutional evidence has been quietly pointing anyway. The Cass Review — which Byrne and Gorin themselves cite — reached its cautious conclusions not from ideology but from the thinness of the evidence for medicalizing minors. When a category is this loose and this self-reinforcing, caution is not cruelty. It is the only sober response to a machine we built ourselves.
James Linehan is an advocate and educator whose perspective is shaped by his experience with congenital hypogonadotropic hypogonadism (CHH), a DSD condition, mirroring the effects of puberty blockers like Lupron
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Excellent, astute column. Let’s break the loop and stop making trans kids and trans people.
Excellent!