The Rise and Fall of the Tobacco Industry and the Gender Transition Industry: A Comparison

Maggie Rose on the striking parallels between smoking and Gender Medicine

Photo by Mathew MacQuarrie on Unsplash

As incredible as it might seem today, for much of the 20th century, smoking was not only widely accepted but actively promoted by medical professionals, celebrities, and government agencies. Tobacco companies poured resources into marketing campaigns that emphasized its benefits, and doctors themselves were often featured in advertisements endorsing certain brands. Yet, as research exposing the dangers of smoking became irrefutable, public perception shifted, leading to a dramatic decline in smoking rates and a stigmatization of the tobacco industry. Today, we see a strikingly similar trajectory in the promotion of gender transition procedures, as medical professionals, pharmaceutical companies, and advocacy organizations aggressively push interventions that have yet to be fully understood in their long-term consequences.

The Medical Promotion of Smoking

In the early 20th century, smoking was not only fashionable but was also endorsed by the medical community. Tobacco companies capitalized on this trust, launching advertisements featuring doctors who reassured the public that smoking was safe, even beneficial. Some brands went as far as to claim that their cigarettes were "physician-tested" and even recommended for throat irritation. In the 1930s and 1940s, brands such as Camel boasted slogans like "More Doctors Smoke Camels than Any Other Cigarette," based on dubious surveys of medical professionals.

Perhaps most shocking were claims that smoking could treat certain respiratory conditions, including asthma. Advertisements suggested that mentholated cigarettes could soothe the throat and help with breathing, a notion that seems absurd today given the well-documented link between smoking and lung disease. Even into the 1950s and 1960s, as early studies linked smoking to cancer and other health issues, the tobacco industry continued to cast doubt on the science, emphasizing personal choice and framing concerns as overblown hysteria.

It was not until the 1980s and 1990s that the tide truly turned against Big Tobacco. Governments implemented stringent regulations, public health campaigns exposed the dangers of smoking, and lawsuits revealed the extent to which companies had knowingly misled the public. Today, smoking is widely recognized as a health hazard, and its former prestige has turned into a stigma.

The Rise of the Gender Transition Industry

A similar pattern can be observed in the rise of the gender transition industry. Just as doctors once promoted smoking as a health aid, many medical professionals today endorse gender transition treatments, even for minors, without fully understanding the long-term consequences. The widespread promotion of puberty blockers, cross-sex hormones, and surgical interventions has been embraced by the medical establishment, often under the banner of "gender-affirming care."

Much like early tobacco marketing, medical professionals are placed at the forefront of the push for gender transition, reinforcing public trust. Organizations such as the American Academy of Pediatrics and the World Professional Association for Transgender Health (WPATH) advocate for early medical interventions, despite growing concerns about their reversibility, long-term effects, and ethical implications. Studies questioning the efficacy and safety of these treatments are frequently dismissed as transphobic, echoing the way early critiques of tobacco were ignored or ridiculed.

Moreover, pharmaceutical companies, which profit immensely from the lifelong dependency on hormones and surgeries, have a vested interest in maintaining this industry. The financial incentives resemble those of Big Tobacco, where corporations thrived on addiction, ensuring that customers remained dependent on their products. The long-term health risks associated with gender transition treatments, including infertility, cardiovascular problems, and bone density loss, are often downplayed, just as smoking’s risks were minimized for decades.

The Cultural Shift Against Smoking and Potential Parallels with Gender Transition

The decline of smoking was not just a medical revelation—it was a cultural shift. As more people became aware of the harms, public perception turned, and smoking transitioned from a glamorous habit to a dangerous vice. The same mechanisms that once promoted smoking—media endorsements, medical backing, and corporate lobbying—eventually collapsed under the weight of undeniable evidence.

A similar shift may be on the horizon for gender transition treatments. Already, several European countries, including Sweden, Finland, and the UK, have pulled back on aggressive medical interventions for minors, recognizing that the long-term effects are not well understood. Detransitioners—individuals who regret their gender transitions—are increasingly speaking out, sharing stories of how they were rushed into life-altering decisions without adequate exploration of underlying psychological factors.

Public sentiment is also beginning to change, with increasing skepticism about the wisdom of medicalizing gender dysphoria, especially in children. While transgender activists and organizations still hold considerable influence, cracks are forming in the consensus, much as they did when the first whistleblowers exposed the tobacco industry’s deceptive practices.

If history is any indication, the medical and cultural embrace of gender transition treatments may follow the same trajectory as smoking. Just as the once-glorified tobacco industry fell from grace, the gender transition industry may face a reckoning as more evidence emerges regarding the risks and regrets associated with these interventions. What was once considered progressive and cutting-edge could become a cautionary tale of medical overreach and corporate greed.

In the future, society may look back on the current era with the same incredulity that we now reserve for cigarette advertisements featuring doctors. Gender ideology, much like tobacco, may transition from a widely accepted norm to a socially unacceptable practice, viewed with regret and disbelief by generations to come. The question is not whether this shift will happen, but how long it will take for the truth to prevail.

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