In January 1992, the heiress who had paid for the invention of transgender medicine in America died in Mazatlán, Mexico, a fugitive from federal drug indictments. Reed Erickson was seventy-four, addicted, and broke. The foundation she had run was long shuttered. The Hopkins clinic she had funded was closed. The professional society she had bankrolled had cut her loose and renamed itself. Almost no one in the field she built was willing to say her name.
None of the men and women who built that field ran a controlled trial or gathered long-term outcome data. What they had instead was institutional prestige, ideological conviction, and, at the decisive moment, one very large fortune. Out of that combination grew the belief system this chapter will eventually name and define: gender ideology. The story runs from Weimar Berlin through postwar Baltimore to its ending in a Winnipeg grocery-store parking lot in 2004.
The European Foundations
The modern idea of gender identity emerged in the early twentieth century, alongside the young disciplines of psychology and sexology. Two men supplied its competing frameworks: Sigmund Freud and Magnus Hirschfeld. Both abandoned the older view that sex was a fixed biological fact, and both cleared intellectual room for radical intervention on the body.
Freud located sexual identity in the mind—in early childhood, family dynamics, and the unconscious. This was the “nurture” side of the coming nature-nurture quarrel. On his account the psyche made something of the body; the body was not simply what it was.
Hirschfeld went the opposite direction. Extending the work of Karl Ulrichs, who had proposed the image of a female soul trapped in a male body, Hirschfeld held that hormones and anatomy placed each person somewhere along a spectrum of as many as sixty-four sexual types, produced by what he called a “glandular orchestra.” In 1919, in the new Weimar Republic, he opened the Institute for Sexual Science in Berlin to put the theory into practice.
In 1922 an employee of the Institute named Dora Richter became the first recorded recipient of what would later be called gender-affirmation surgery: a castration performed by Erwin Gohrbandt, who went on to perform the first surgeries constructing an artificial vagina. The Institute also experimented with hormones, dosing patients with crude extracts boiled down from animal glands.
Its most famous patient was the Danish painter Einar Wegener, who in 1930 underwent castration and penectomy and received an implanted ovary, taking the name Lili Elbe. Elbe died the following year, after a further operation, in what one account of the case called “an abyss of suffering.” The death changed nobody’s practice.
In 1933 the Nazi Student Union and the SA raided the building, hauled its library and patient records into the Opernplatz, and burned them. Dr. Ludwig Levy-Lenz, who had assisted Gohrbandt on the early operations, later offered a theory of the arson: “We knew too much… Our knowledge of such intimate secrets regarding members of the Nazi party and our other documentary material—we possessed forty thousand confessions and biographical letters—was the cause of the complete and utter destruction of the Institute for Sexology.”
The Institute’s staff scattered. Some stayed and served the regime; Gohrbandt became the Luftwaffe’s chief medical officer and helped run the freezing experiments at Dachau. Others emigrated, and the emigration carried Hirschfeld’s ideas and Freud’s into the medical and academic networks of the United States, where a European pedigree could stand in for the evidence no one had produced.
Nor did the practice die with the Institute. After the war its center of gravity shifted to Denmark, where the endocrinologist Christian Hamburger had received nearly five hundred written requests for sex change by the mid-1950s—and where the surgical results were as dismal as Berlin’s.
Kinsey’s Spectrum
The most consequential American to inherit this material was Alfred Kinsey, whose research in the 1940s shaped nearly every theory of sexuality that followed. Its flaws were built into the foundations. Kinsey drew heavily on prisoners, prostitutes, and sex offenders, then generalized from them to the population at large; his portrait of “normal” sexuality was distorted at the source, and everyone who built on his numbers inherited the distortion.
The move that mattered most was the Kinsey Scale. By spreading sexuality across a continuum from zero to six, Kinsey converted what people had always treated as distinct categories into a smooth gradient. It had the look of scientific precision and none of the substance. The same logic would be applied to gender a generation later.
His cover was institutional: Rockefeller Foundation money and a post at Indiana University. This is worth noticing, because it becomes the template—an idea wins acceptance through funding and prestige rather than replication. When the transvestite activist Louise Lawrence made contact with Kinsey in 1948, it was as an advocate, feeding Lawrence’s own network of contacts into Kinsey’s data, which Kinsey was glad to accept. The activism was already inside the research.
Harry Benjamin and the Patient Who Disappeared
Harry Benjamin brought Hirschfeld’s ideas across the Atlantic himself. A German-American endocrinologist who had emigrated in 1913, he had studied at the Institute and kept up with its work for decades, so that when American medicine met its first cases he had a running start no colleague could match.
The case that made his career arrived in 1948. Kinsey, then in San Francisco, met a young patient who was anatomically male but insistently identified as female, and sent the patient to Benjamin. Both men expected transvestism—the recognized diagnosis for cross-dressing men, understood as a compulsion that left the underlying facts of sex undisturbed. This was something else. The patient did not want to dress as a woman but to be one and demanded that medicine make the body conform to the claim. Out of that distinction came a new category: transsexualism, a gender identity at war with biology and calling for surgical rather than psychological treatment.
Benjamin prescribed estrogen, which he said had a calming effect, and arranged for the patient and the patient’s mother to travel to Germany for surgery, over the objections of the psychiatrists he consulted. Then the two left, and he never heard from them again. He had no follow-up on the first transsexual case of his career, and the vanished patient set the pattern for what followed: intervention without observation, granted on demand rather than earned by evidence.
Benjamin’s own contributions—the 1966 Sex Orientation Scale, the “triadic therapy” of real-life experience, hormones, and surgery — were modeled on Kinsey and reproduced his errors. The scale assumed gender identity ran along a continuum and that “true transsexuals” could be sorted from the rest by clinical judgment, though no objective test existed to do the sorting. Triadic therapy became the standard of care by consensus, never by trial.
His 1966 book, The Transsexual Phenomenon, did the rest. Fifty-one case studies, no controls, no standardized measures, no long-term data — and it became the founding text of the field anyway. The historian Vern Bullough credited it with pushing “transsexual,” an obscure coinage of David Cauldwell’s from 1949, into ordinary American speech. Activists called the book the “transsexuals’ Bible,” which was an accurate description of what it was: a movement document wearing a lab coat.
The Heiress Who Built the Field
None of it would have reached scale without Reed Erickson.
She was born Rita Alma Erickson in El Paso in 1917, into a German-Jewish family in the lead-smelting business, and in 1946 became the first woman to graduate from LSU’s mechanical engineering program. When her father died in 1962 she inherited Schuylkill Products and Schuylkill Lead; the companies sold to Arrow Electronics in 1969 for about $5 million, and shrewd bets on oil-rich real estate did the rest. By the 1970s her monthly income ran into six figures and her fortune past $40 million.
In 1963—the year after the inheritance—Erickson became a patient of Harry Benjamin’s and began transitioning, with surgery following in 1965. From the beginning, the funder of American transgender medicine was the same person undergoing its procedures.
In 1964 she founded the Erickson Educational Foundation. Its stated purpose was to back “research too new, controversial, or imaginative” for conventional funders. Its actual purpose, visible in its own records, was to build the institutional base for transsexualism in America.
The disbursements add up to a field. The Harry Benjamin Foundation drew more than $60,000 between 1964 and 1968—enough to incorporate in 1967 and open its doors. The Johns Hopkins Gender Identity Clinic, the first of its kind in North America, took in roughly $72,000 between 1967 and 1973, its formative years. ONE, Inc., the homophile organization that became a fixture of gay activism, received more than $2 million over two decades. The first three International Symposia on Gender Identity, in 1969, 1971, and 1973, were paid for and largely organized through the foundation. Those symposia grew into the Harry Benjamin International Gender Dysphoria Association, which in time renamed itself the World Professional Association for Transgender Health.
Subtract Erickson and the architecture disappears—no Hopkins clinic, no Benjamin Foundation, no early WPATH. An entire branch of American medicine rested on one donor’s checkbook.
The universities did not embrace transsexualism because the science compelled them. They embraced it because the money paid for clinics, conferences, fellowships, and journals, and because no one was funding the skeptics. The clinics supplied the patients and the conferences set the consensus, which the journals then cited into authority. A donor with $40 million and a personal stake in the findings could build a self-reinforcing professional consensus that ran independent of evidence, and that is what she did.
By the late 1970s Erickson had a serious drug habit, had moved to Southern California, and after a string of arrests had fled to Mexico. She died in Mazatlán on January 3, 1992, at seventy-four, wanted in the United States. The foundation had folded years before, its residual work handed to the Janus Information Facility under Paul Walker. But the mechanism she had installed outlived her, and it is recognizable today: a small number of well-funded donors underwrite an ideological consensus, and the universities and clinics ratify it as science.
John Money’s Parallel Track
John Money supplied the academic engine, and his own history is hard to keep out of the account. Born in New Zealand in 1921, he was a slight, delicate boy raised, as he put it, inside “tightly sealed, evangelical religious dogma.” Bullied at five, he retreated with a girl cousin into the girls’ play shed and decided that, having “not measured up as a fighter, I was set on the pathway of outwitting other kids by being an intellectual achiever.” His father died when he was eight, and the household of mother and aunts that remained had, by his account, “nothing good to say about men.” He described his own reaction with a frankness that is difficult to read past: “I suffered from the guilt of being male. I wore the mark (a penis) of man’s vile sexuality… I wondered if the world might really be a better place for women if not only farm animals, but human males were gelded.” He lost his faith in his twenties and turned against what he called the “anti-masturbatory, anti-sexual fervor” of his childhood. The later work does not sit comfortably apart from those sentences.
He came to Johns Hopkins in 1952 with a Harvard PhD and a research program on children born with ambiguous genitalia. His thesis: a child’s eventual gender role is fixed not by biology but by how parents and doctors treat the child in the first year or so of life. The “gate,” as he described it, “is open at birth for a normal child no less than for one born with unfinished sex organs… and stays open at least for something over a year after birth.” His 1955 paper coining “gender role” presented this as a finding. It was a hypothesis that never found its evidence.
Between 1964 and 1967 he joined a Benjamin-led team — Doorbar, Green, Guze, Kupperman, Pomeroy, Wollman—underwritten by Erickson. The collaboration produced the Johns Hopkins Gender Identity Clinic, which opened in July 1966, and the Harry Benjamin Foundation the following year. Benjamin himself gave Money the credit for bringing such “an august institution” as Johns Hopkins Hospital around to endorsing sex-change surgery for adults.
By then the adult outcomes were already poor. Money’s explanation was that surgery failed on adults because they arrived with identities already set, and his remedy was to operate sooner—on children, and ideally on infants, before socialization could take hold. Nothing supported the move. He had the position, the Erickson money, and a willing hospital, and that turned out to be sufficient.
The David Reimer Case
In 1966 an eight-month-old boy named Bruce Reimer was brought to a Winnipeg hospital for a routine circumcision. It went catastrophically wrong and destroyed his penis. The specialists his parents saw offered only bleak forecasts—he would never urinate normally, never have sex, never father a child; one psychiatrist said he would “never marry and must live apart.” Then the Reimers saw John Money on television, explaining that gender identity came from social learning rather than biology, and they took their son to Baltimore.
Money saw an opportunity no ordinary clinician would have seen. Bruce had an identical twin. Two genetically identical children could be raised as opposite sexes, a design Money would later admit would be “ethically unthinkable” to construct on purpose. This one had arrived on its own.
He persuaded the parents to castrate the boy and raise him as a girl, Brenda, and told them he saw “no reason” it would not work. At twenty-two months Bruce was surgically castrated and renamed.
It failed almost immediately. The child rejected everything feminine, fought without letup, and stood to urinate; teachers said they had never seen anything like it in a girl, and by eighth grade classmates were calling the child “Cavewoman.” Janet Reimer, the twins’ mother, sank into a severe depression and attempted suicide. The annual follow-ups at Hopkins were episodes of abuse: Money showed the twins pornography, had them rehearse sexual positions on each other while he photographed them, and—in Reimer’s own later words—subjected them to “brainwashing” and “psychological warfare.” By seven the child was threatening to kill himself rather than go back.
None of that reached print. In his 1972 book Man and Woman, Boy and Girl, Money reported that the child’s behavior was “so clearly that of an active little girl and so different from the boyish ways of her twin brother.” Time reported the case as “strong support” for the women’s movement, and it became the textbook proof that gender was a social construction. In Sexual Signatures (1976), written with Patricia Tucker, he pronounced the experiment an “utter success,” wrote that the annual follow-ups had “proved how well all [parties] succeeded in adjusting to that decision,” and prescribed estrogen to bring on breast development.
It was invented. In Winnipeg the psychiatrists actually treating the child were recording masculine behavior and acute distress, and Money ignored their reports. Pressed about the vaginal surgery he wanted done, the child ran from the room screaming. By 1979 BBC investigators had assembled enough of the truth to film Dr. Keith Sigmundson saying on camera that he was “very suspicious that she will ever make an adjustment as a woman.” Money kept promoting the case as a triumph and told colleagues he had simply “lost contact” with the family.
In 1980, at fourteen, Reimer attempted suicide, and his parents finally told him the truth. Within days he decided to live as a man and took the name David; testosterone injections followed, and surgery to remove the breasts the estrogen had produced. The public did not learn any of it until 1997, when the journalist John Colapinto broke the story in Rolling Stone and then in his book As Nature Made Him (2000). The rest of David’s life was hard—work that would not hold, strained relations at home, a marriage coming apart at the end. His twin died of a drug overdose in 2002. In May 2004 David shot himself in a grocery-store parking lot. Money never addressed Colapinto’s reporting or the suicide, and went on defending sex-change surgery until his own death in 2006. After the story broke, other former patients came forward with accounts of the same abuse and the same lasting damage.
The 1979 Retreat That Did Not Hold
The Reimer case eventually forced a reckoning at Hopkins, though a limited one. In 1979 the hospital closed its Gender Identity Clinic. Studies by Jon Meyer and Donna Reter had turned up no evidence that the surgeries improved patients’ lives over the long run. Paul McHugh, brought in as chief of psychiatry in 1975, made the argument in plain terms: gender identity was not an innate property standing apart from biology; the operations were untested treatments for what were, at bottom, mental disorders; and the existing studies had been bent toward the conclusions the clinicians already favored. He shut the program down.
It did not hold, because the academic project had never needed the clinic. While Hopkins was closed, the theory kept spreading through the universities, and the professional network Erickson had funded went on running its symposia, training clinicians, and pressing for the clinic’s return. When Hopkins finally reopened in 2017—as the Center for Transgender Health, since renamed the Center for Transgender and Gender Expansive Health—gender ideology had already moved out of the clinic and into the schools, the courts, corporate HR, and the culture at large. The clinic no longer set the consensus. It followed it. What McHugh had established in 1979 was never refuted on the merits. It was simply bypassed.
So much for the history of the apparatus. It leaves a question the narrative alone cannot answer: what, exactly, is the belief system that all this machinery was built to serve? Money and Benjamin and their funders gave us the practices and the euphemism that still cloaks them—“gender-affirming care.” But the ideology behind the practice draws on a much larger cast, and it deserves to be named precisely and examined in the open.
Naming the Thing
We use the phrase “gender ideology” deliberately, and against the express wishes of the outlets that report on it. A recent AP style guide instructs journalists to “not use the term transgenderism, which frames transgender identity as an ideology.” Wikipedia does its part too: the “anti-gender movement,” it explains, opposes what it calls “‘gender ideology,’ ‘gender theory,’ or ‘genderism’”—concepts that supposedly “have no coherent definition.” The encyclopedia quotes European academics who pronounce the term an “empty signifier” and files its users under “right-wingers and the far right, right-wing populists, conservatives, and Christian fundamentalists.”
Notice the actual claim. It is not merely that “gender ideology” is unfair or imprecise, which is the AP’s complaint. It is that the phrase refers to nothing at all. But a word that thousands of people use to pick out the same set of facts in the world has, by that very use, both a meaning and a referent, whatever its origin and however much its targets would prefer it left unspoken.
And we know this ideology by its work. It is what adds each new letter to the ever-lengthening initialism after LGB. It is what persuades school districts to let males who identify as female into girls’ sports and girls’ locker rooms. It is what induces the press to describe the man who won the 1976 Olympic decathlon as a woman. It split the old LGBT coalition down the middle, radical feminists and gay men on one side, the TQ+ contingent on the other. It is the source of the claim that a child can be born in the wrong body—that when a girl is anguished about her biological sex, the answer is to alter the body and everything around it, her name and pronouns and bathroom, rather than help her make peace with the body she has. It is why Judge Ketanji Brown Jackson, asked during her confirmation hearing what a woman is, could answer only, “I can’t… I’m not a biologist.”
It is also why the Babylon Bee’s headline—“Bigoted Gender Surgeon Still Only Offering ‘Male’ and ‘Female’”—lands. You get the joke, which means you already know what gender ideology is. Pretending otherwise is a pose.
A good definition makes explicit what a term’s users already grasp without saying. A good definition of an ideology should also capture how its adherents talk, even when those adherents would rather the thing work quietly in the background than stand under a bright light and be examined.
Gender ideology resists definition more than most positions, because its proponents run a perpetual game of motte-and-bailey—retreating and advancing between claims, redefining ordinary words and minting new ones that make sense only inside the system. You cannot define the ideology without using the vocabulary it has already smuggled into the language, and that vocabulary needs defining too. It can still be done. Gender ideology, as of 2025, is the view that (1) the sex binary fails to capture the full complexity of human experience, and (2) a person is most fundamentally described not by sex but by an “internal sense of gender”—a “gender identity”—that may be at odds with the “sex assigned at birth.”
The definition captures the way adherents use “gender” as shorthand for “gender identity.” It also decodes that other great euphemism, “gender-affirming care”: care that affirms the patient’s felt gender identity, even at the cost of the patient’s fertility, sexual function, and healthy sex organs. Outside the system, the same procedures look like sex-rejecting quackery—but that is a separate argument.
Like any definition, this one leans on terms it does not itself define, and here the standard sources are no help, because they are circular. Google’s dictionary calls “gender identity” a person’s “innate sense of gender,” usually invoked in contrast with the sex recorded at birth. Every other source runs the same loop: gender identity is an internal sense of gender. The circularity is unavoidable, because inside this framework gender can never be anchored to sex. Its partner phrase gives the game away. “Sex assigned at birth” sounds like a neutral description; its real function is to reclassify sex as a social imposition without admitting as much. That is why committed adherents, when speaking carefully, will say “sex assigned at birth” where the rest of us would simply say “sex.” The lexicon is so far embedded that a search for “the sex binary” will redirect you to pages debunking the “gender binary,” and even Scientific American has fallen into line.
Why the shell game? Why insist the view cannot even be named? Because the adherents need it taken for a plain finding of science rather than what it is—a doctrine strange enough that few would accept it if it were spelled out plainly and without the threat of social punishment for dissent. So, for this book: gender ideology is the subordination or replacement of the facts of biological sex by notions like “gender identity” and “sex assigned at birth.”
Out of the Depths
How did we arrive here? Gender ideology, like most mongrels, has a mixed and dubious pedigree—strands of critical theory, French postmodernism, feminism, and the odd Johns Hopkins technocrat like John Money, as sketched above. Tracing the whole family tree would take a book of its own. But the essential story can be told through a single shift: the way English speakers came to use the words “sex” and “gender” over the twentieth century.
The two words have long overlapped—one sense of “gender” was synonymous with “sex” as far back as the fifteenth century — but for most of their history their centers of gravity sat far apart. “Sex” was the biologist’s word, since the distinction runs through the living world and not only through us; it would sound strange even now to ask after the “gender” of a fruit fly or a holly tree. “Gender” had the wider semantic range, but until the twentieth century its predominant sense belonged to grammar—the masculine, feminine, and neuter forms of words in languages like German and French. An English speaker learning German refers to a noun’s gender, never its sex.
Two changes moved the words together. First, over the twentieth century “sex” came to name the act as much as the category, which gave speakers in polite company a reason to reach for the less loaded “gender” when they meant the difference between men and women. Then, in the 1950s and 1960s, feminists and other theorists made the drift into doctrine: “sex” would name the biological difference, “gender” the psychological and social freight attached to it. The purpose was fair enough—to attack the stereotypes that had confined women. Why should reproductive anatomy dictate a woman’s education, her profession, or her place?
But the distinction had no basis in the history of the words, and it left a crucial line undrawn. Where does biology end and convention begin? Is the tie between ovaries and womanhood a fact or a custom? What about the impulse to nurture a child, or a fondness for the color pink? The theorists rarely said. In the 1970s a more radical cohort faulted their second-wave elders for conceding too much—for still treating sex as fixed—and pushed steadily more of what had been biology across the line into convention. Over the same years “gender” all but swallowed “sex,” down to the boxes on medical forms. And finally “gender” itself gave way to the slipperier “gender identity.”
The provenance of that phrase is often misattributed. Money coined “gender role” in a 1955 paper, but the philosopher Alex Byrne has shown that “gender identity” first appears with the psychologists Robert Stoller and Ralph Greenson in 1963—and that their definition, startlingly, took the reality of sex for granted. Gender identity, they wrote, “is the sense of knowing to which sex one belongs.” A male can sense, and indeed know, that he is male; a female likewise. Had they called this awareness “sex identity,” they would have saved everyone a great deal of trouble. Instead their sober definition was swallowed by the fog of the gender revolution that followed.
Stoller himself showed how fast the sober version could curdle. By Sex and Gender (1968), written out of the gender identity clinic he had helped establish at UCLA in the mid-1960s, he was arguing that although “sex and gender seem to common sense inextricably bound together,” the two “may go in quite independent ways”: “gender role is determined by postnatal forces, regardless of the anatomy and physiology of the external genitalia.” Girls, on this account, can have penises. And gender identity, once set by rearing in the first eighteen months or so, was in Stoller’s judgment so stubborn that it would be easier to change an adolescent’s body by surgery than to change his sense of himself—a perfect inversion of the old common sense, and the working premise of the surgical program to come.
That revolution owed most to a line of “gender theorists” who took hold first in the academy and then, through consultancies, training programs, and professional bodies, in the wider culture. The philosophical warrant came from Simone de Beauvoir. The Second Sex (1949) opens by asking what a woman is, and answers that “one is not born, but rather becomes, a woman”: no biological, psychological, or economic fate fixes the figure the human female presents in society; civilization as a whole produces her. To those who supposed the body places limits on social roles, Beauvoir answered flatly—“the situation does not depend on the body; the reverse is true.” What matters is how we conceive the body, and how we conceive the body is gender. Follow the thought to its end and there is no natural man or woman at all, only construction all the way down, with technology—contraception, abortion, and in time genetic engineering—free to manufacture the new woman and the new man.
A few feminists saw where this pointed. Janice Raymond’s The Transsexual Empire: The Making of the She-Male (1979) warned that the movement then taking shape would end by erasing women—right about the direction, and thirty years too late about the premises. Donna Haraway, Hélène Cixous, and Luce Irigaray carried the constructionist line forward. But none was as influential as Judith Butler.
In Gender Trouble (1990), Butler argued that “there is no reason to assume that genders ought also to remain as two. The presumption of a binary gender system implicitly retains the belief in a mimetic relation of gender to sex whereby gender mirrors sex or is otherwise restricted by it.” This went past Money, who thought children began gender-neutral and were socialized into a role but never denied the biology of sex outright—and past Beauvoir, whose becoming-not-born formula was by then settled orthodoxy. Butler’s move was to make both sex and gender into performances, and womanhood a matter of self-determination rather than body.
And she pressed past the surgeons. The clinicians performing reassignment operations were, on Butler’s account, reinforcing the very binary they claimed to transcend—castrating a boy makes a girl only in a world that still believes in boys and girls. The project she laid out across Gender Trouble and Undoing Gender (2004) was larger: a world in which everyone questions their gender, in which sex and gender alike are “performances,” and drag queens, butch and femme, and the whole taxonomy of deviation are prized precisely for the trouble they make. A performance needs an audience, so the politics became a politics of recognition. “We are not carving out a place” for mere private liberty, she writes; persons “cannot persist without norms of recognition”—without teachers, parents, employers, and the state affirming the performance, the new “sense of personhood” cannot hold, and the unaffirmed are left with a “pervasive sense of their own unreality, which can lead to suicide or a suicidal life.” The body sets no limit; the limit is “fantasy,” an “internal film that we project inside the interior theater of the mind.” From there the practical conclusions write themselves: the binary bathroom and the girls’ team are instruments of oppression, affirmation is a moral emergency, and the doubter is not a dissenter but a danger, to be brought along or silenced.
Butler is famous, deservedly, for prose of remarkable difficulty, and the difficulty does real work: it hides the thinness of the argument. It has not held her back. Her ideas saturate gender and feminist studies, sociology, philosophy, and much else. For a clear-eyed dismantling, the reader can consult Byrne’s Trouble with Gender (2023) or the 2025 Department of Health and Human Services report on pediatric gender medicine.
The classroom version of all this elevates gender identity higher still, and its distilled form is the “Gender Unicorn,” a catechism in cartoon that teachers use to initiate elementary-school children into the mysteries. Sex, the Unicorn explains, is merely assigned. Gender identity simply is.
The Trouble with Gender Identity
Why believe any of it? No one has ever won a Nobel Prize, in medicine or anything else, for discovering that every human being carries a “gender identity” that can diverge from the body. And a trans identity—male identifying as female, or the reverse—is only one option in the current scheme. There are nonbinary, agender, demiflux, two-spirit, genderfluid, genderqueer, and an open-ended list of others, none corresponding to any biological state; even those who identify with their “sex assigned at birth” are said to have a gender identity, namely cisgender.
Grant for a moment that gender identity exists. The only evidence for it is the first-person testimony of the person reporting it—testimony that is often changeable and cannot be checked against anything. No blood panel, no genetic screen, no MRI or CT or PET distinguishes the demiflux from the two-spirit from the nonbinary. Nor is the problem only for the natural sciences; there is no argument—theological, philosophical, literary, architectural, take your pick—that establishes that anyone has a gender identity at all, let alone that law and culture should bend our knowledge of biology to accommodate it.
There is really only one way to say what a given gender identity is without falling into circularity or pure assertion, and it is fatal to the project: one has to reach for sex stereotypes. Consider a nine-year-old boy who reports that he prefers dolls to G.I. Joes, plays mostly with girls, and likes jewelry and cosmetics. To the gender ideologue this is evidence not merely that the boy might be sex-atypical or have gender dysphoria, but that he has a female gender identity—that he is, in some sense said to run deeper than biology, a girl. Which means that to be female is, at bottom, to like the things girls are stereotyped as liking. That is not remotely what English speakers mean by “girl” or “woman,” and it cannot account for identities like “nonbinary” and “agender” that are supposed to match neither sex. Strip away the biological referents of male and female, man and woman, and stereotypes are all that is left. The gender ideologue ends up caught between circularity on one side and mere convention on the other—pinned by exactly the conventions the first feminist theorists set out to escape.
So, to summarize: “gender identity” has no history in English and no older synonym. Every attempt to define it collapses into either circularity or stereotype. Our access to the thing it supposedly names is wholly subjective and empirically ungrounded. No one is credited with discovering that human beings have such a thing, still less that it, rather than the body, tells us who someone is. And the ideology built on it requires, in the end, that sex be demoted to a social construct.
The Reality of Sex
Set against that, the basic facts of sex are about as firmly established as anything human beings know. Every culture in every era, however isolated, has arrived at the categories of male and female, and sorts the same individuals into them the same way. The plainest explanation is that sex is something cultures observe in the world, not something they invent and impose on it.
Every culture also grasps that sex has to do with reproduction. Sex is, in the biologist’s terms, a reproductive strategy. Human beings, like a vast range of plants and animals, reproduce by fusing gametes of two different sizes—anisogamy. Females, developing normally, have a reproductive system built around the large, immobile gamete, the ovum; males, developing normally, have the complementary system built around the small, mobile gamete, sperm. There is no third gamete and no gradient between the two, which is what it means to say that sex is binary. Some people have disorders of sexual development and do not fully form one system or the other; that can make an individual’s sex harder to read, but every such disorder is a disorder of a male or a female. There is no third thing for it to be a disorder of.
At its core, then, sex is two complementary reproductive systems and their gametes. But the difference radiates outward into a long list of measurable others. Unlike the binary of sex itself, most of these are distributed bimodally, which is fully consistent with a binary: some women are taller or stronger than some men, yet men and women differ on average in height, weight, strength, bone density, and aspects of brain function. Men tend to do better on tasks involving spatial and geometric reasoning, women on verbal fluency, memory, and articulation—differences that the best evidence traces not to socialization but to the action of hormones on the developing brain and to greater brain asymmetry in men. Sex shows up in how children play, in how finely people discriminate colors (women, on average, more finely than men), and in how bodies absorb and metabolize drugs. A 2023 paper in Physiology & Behavior concluded that the biological differences between the sexes shape “a wide spectrum of physical, psychological, cognitive, and behavioral characteristics” across the whole of adult life. Men and women are equal in dignity and in rights. They are not the same, and the difference is not, mostly, a thing humans made up.
To reduce all of that—the reality of men and women—to a label a doctor pins on a newborn is not a sophisticated position. It is a plain falsehood, and no law, ruling, lesson plan, or clinical protocol built on it deserves our sanction or our respect.
The Pattern
Step back and the shape is clear enough. Hirschfeld, Benjamin, Erickson, Money: at each stage a theoretical commitment gathered enough institutional weight that the absence of evidence stopped counting against it. The donor wrote the checks, the clinician ran the ward, the theorist supplied the cover—and no one along the chain produced a controlled trial. What they produced was an industry, and the industry outlived every one of them. Erickson died a fugitive in 1992 with her field intact. Money died at Hopkins in 2006 without retracting a line. David Reimer, who was made into the proof of a theory before he could speak for himself, died in a parking lot in 2004. The institutions the theory built are still open — not because the argument was won, but because it was never really had.
The intellectual line runs just as straight. What began as the claim that women are not born but made ended, two generations on, with a Supreme Court nominee unable to say what a woman is. Each step followed from the last: detach sex from gender to free women from the stereotype; concede that anatomy is not destiny; then find the concession has no stopping point, until the body means nothing and every person is invited to perform a gender of his own devising. It is one thing to say anatomy is not destiny. It is another to say it is nothing. Anatomy may not be destiny, but it ain’t nothing.
The evolution of feminist theory & the emergence of gender ideology.
The transformation of gender theory from medical practice to comprehensive ideology was significantly accelerated by developments in feminist and postmodern academic theory. For centuries, English speakers had used “sex” and “gender” interchangeably to refer to the natural differences between male and female, with “gender” applying especially to grammatical categories in languages. In the 1950s and 1960s, however, feminists and other theorists began distinguishing these terms: “sex” would be reserved for biological differences, while “gender” would refer to psychological and social aspects.
This distinction initially served to critique social conventions and stereotypes that feminists argued had led to women’s oppression. But this theoretical innovation introduced a conceptual framework that had no basis in the etymology of these words and failed to clarify where biological effects allegedly ended and social convention began. The ambiguity about whether associations like ovaries with females, desires to nurture children, or preferences for certain colors represented biology or convention created theoretical instability that would prove crucial for later developments.
In the 1970s, more radical feminists critiqued their “second-wave” predecessors for still conceding that sex was an immutable characteristic. Following the postmodern drift of Western academia, these theorists assigned more and more territory once reserved for biology—”sex”—to mere social convention—”gender.” This theoretical trajectory culminated in the work of several influential “gender theorists” including Simone de Beauvoir, Donna Haraway, Helene Cixous, and Luce Irigaray, who gained popularity within academia and influenced public discourse through consulting firms, training programs, and professional organizations.
The most influential figure in this theoretical evolution was Judith Butler, a professor at the University of California–Berkeley, who burst onto the scene in 1989 with Gender Trouble: Feminism and the Subversion of Identity. Butler argued that “there is no reason to assume that gender also ought to remain as two. The presumption of a binary gender system implicitly retains the belief in a mimetic relation of gender to sex whereby gender mirrors sex or is otherwise restricted by it.” This went far beyond John Money’s theories from two decades earlier—while Money believed children started gender-neutral with socialization determining their future gender, he did not dismiss biological sex altogether.
For Butler, both sex and gender became not only social constructs but performances, expanding on Simone de Beauvoir’s 1949 claim that “one is not born but rather, becomes a woman.” Butler’s theory suggested that being a woman was a matter of radical self-determination rather than biology. Despite her notoriously obscure prose—which serves to camouflage weak arguments—Butler’s ideas became nearly ubiquitous in gender and feminist studies, education, sociology, philosophy, and many other disciplines.
This academic theorizing provided the intellectual framework that would later be translated into practical applications. The concept of “gender identity” itself, while sometimes attributed to John Money, was actually first used by psychologists Robert Stoller and Ralph Greenson in 1963, who ironically defined it as “the sense of knowing to which sex one belongs”—a definition that presupposed the reality of sex. This original definition was soon obscured by the theoretical developments promoted by Butler and other gender theorists, who transformed “gender identity” from sex recognition into something supposedly independent of biological reality.