Alice Dreger's new book, Galileo's Middle Finger, is a curious addition to the literature of the anti-trans movement from a woman who has done some very good work on those who are genitally intersex. Unfortunately, her claim about searching for the truth as an activist, anti-activist, and historian falls apart on several very important points.
To review, Professor Dreger is a friend of Professor Michael Bailey, whose exploits with the trans community in the early aughts was described in his infamous The Man Who Would Be Queen. I reviewed the current attempt to rehabilitate Dr. Bailey by several of his friends, including Dr. Dreger, in a recent Huffington Post column. I've recently read her book as well as two reviews which just appeared in The New York Times and The Washington Post.
The best description of the book is that it's a rant, and an extremely tedious one at times, delving into a level of detail which bored even me, (and I'm familiar with most of the characters), by a woman I would call a neoconservative sexologist. Having performed the grueling work of an activist in helping protect newborns with ambiguous genitalia from mutilating surgeries without informed consent, she turned, grudgingly by her description, to protecting Professor Bailey from his trans critics. Her analysis of the behavior of the trans activists left her in such despair that she became a self-described "anti-activist." This shift in thinking is reminiscent of the political neocons who were once proud leftists but turned towards the hard right during the Reagan years out of a sense of betrayal by their former colleagues.
As an historian, and one who is deeply concerned with her reputation as a truth seeker, she candidly admits the object of her concern is not without flaws. After admitting that she is not a scientist, she almost immediately claims that there is little evidence to back up the consensus position on human sexual development. Either she's lying, or hasn't done her homework. As I've presented, the developing consensus was already publicly available back in 2005 in a publication co-authored by many of the luminaries in the field, called "Atypical Gender Development." In the ensuing decade the evidence has continued to pile up, but it has had no impact on her search for the truth. She still considers the consensus as ideologically biased and intent on a witch hunt, led by a number of well-known and highly successful trans activists. That one of these women is a well-respected economist (Deirdre McCloskey) and another is one of the most important inventors in American history (Lynn Conway) has no effect on her critique. Poor Professor Bailey has been attacked and must be defended by her, her actions enabling others to rise to his defense as well.
This non-scientist then admits that Bailey's work on the trans community is not based on his own research, but is just his contribution to promoting the work of a Dr. Ray Blanchard. Dr. Blanchard is on staff at the notorious gender clinic associated with the University of Toronto (Centre for Addiction and Mental Health) known as "Jurassic Clarke." Dr. Blanchard's typology of transsexualism, based on nothing more than his personal mode of classification, divides trans women (and note, there is never any talk of trans men, which in itself condemns this research, begun in the '80s, as utter nonsense) into two categories -- extremely feminine gay men and perversely erotically-driven cross-dressing men. There is no science to this analysis. There are no randomized and blinded studies, and no research into non-trans women who exhibit similar behavior. These Freudian constructs of Dr. Blanchard and his close friends and colleagues, including Drs. Bailey and Ken Zucker, are not based on objective criteria, but are rooted in the assumption that gender identity doesn't exist and the trans phenomenon is composed of two different forms of sexual orientation. Unfortunately for them, the existence of gender identity (in the context of an intersex condition called cloacal exstrophy) was proven in 2004 by Dr. William Reiner, then at the Johns Hopkins School of Medicine, and today the number of people who believe that transsexualism is a type of sexual orientation is similar to the number of climate change deniers. This small number is evidence for Dreger that they are actually a small remnant that is struggling to tell the truth to a politically correct, brainwashed mainstream of medical doctors and psychologists, who've been intimidated by trans women who happen to make up an overwhelming 0.15% of the population.
Dreger writes that the trans community organized against Bailey because his exposition of Blanchard's thesis was so potent and accessible to the general population that it was far more dangerous than Blanchard's dry clinical research. Dr. Bailey is a charming man, who does claim to believe in sexual liberation and that all trans women should have access to full medical and surgical care; he's just trying, according to Dreger, to bring them into the light about their reality. And while Bailey has done some good clinical research on homosexuality, he knows nothing of the trans experience other than the fact that certain trans women arouse him sexually. That sets him apart from Blanchard, apparently.
So we have Blanchard, a Canadian researcher associated with a reparative therapy clinic in Toronto which is currently under investigation, peddling philosophical pseudoscientific junk which was current in the '70s (and promoted by Stonewall veteran, Jim Fouratt), who ignores the current scientific consensus and is allowed to continue to publish by the same colleagues who published Dreger's defense of Bailey. It's ironic that Dreger, who cares so much for the scientific method of peer review, ignores the cozy little cabal that runs the Archives of Sexual Behavior, which has cross-promoted its members research and pretended to be fairly peer-reviewed. It's no small matter, because the DSM 5, the psychiatric manual which is used by courts and legislatures as well as medical providers to help them understand and classify a host of conditions and disorders, was heavily biased towards this little cabal (the workgroup tasked with organizing the revision was directed by none other than Ken Zucker) and ended with the retention of a classification of Transvestic Disorder to placate the lonely Dr. Blanchard.
It's also ironic that in her efforts against the experimental use of the potent steroid, dexamethasone, to prevent the development of Congenital Adrenal Hyperplasia (CAH) in embryos, she attacks the work of Dr. Heino Meyer-Bahlburg, another member of the Zucker-Blanchard-Bailey brotherhood. She's distressed because he's motivated by his desire to see these girls with CAH grow up in a classical gendered role with the desire to be feminine and become mothers. I agree, and find it hard to believe such unethical behavior is still permitted in 2015. The use of prenatal hormones without informed consent by Dr. Maria New and others, in light of the disaster which was DES from 1948-1971, and which Dreger mentions, is a disgrace, but unsurprising in both a scientific community and general public that prefers its head buried in the sand when it comes to sexuality. She titles her paper, "An Ethics Canary in the Modern Medical Mine," reminiscent of my talks on DES, the endocrine disruptor "canary in the coal mine," shown to be a cause of transsexualism. This is a fact that Dreger conveniently ignores, because the genetic and epigenetic etiologies of transsexualism don't fit with either of Blanchard's two classes.
Galileo "gave the finger" not to the scientific community but to the anti-science Church, which continues to this day its hatred of human sexual variation, and particularly trans women. Science, like every human endeavor, is rife with bias and personal conflict, and dependent on evolving modes of funding (and funding for research on sexual development is very hard to come by in our prudish nation). But the scientific method is the best way to get to the truth, even when it takes many years to revolutionize our way of thinking (as first described by Thomas Kuhn back in 1962 in The Structure of Scientific Revolutions).
A woman who has done good work on clinical intersex conditions but is admittedly an amateur when it comes to science is in no position to determine the adequacy of the mass of scientific research which she ignores or the value of a single paper which she praises. When those actions, which ironically are indirectly supported by religious conservatives, such as Paul McHugh, associated with the Church challenged by Galileo, call into serious doubt the humanity of a class of people who are already severely oppressed, then her writings become dangerous and encourage further cruelty.
Fortunately the Bailey book catalyzed the modern era of trans activism, which has continued to change lives for the better. We owe a great debt to those trans activists who stood up to Bailey and put the psychiatric community on notice. The revision of the DSM, the upcoming revision of the WHO's ICD classification of all medical conditions, the growth of the World Professional Association for Transgender Health (WPATH), and the remarkable growth in the number of well-trained, compassionate gender therapists have all occurred in the wake of that battle at the turn of the century.