Is the U.S. State Department about to classify Sweden, Finland, and the U.K. as human rights abusers? According to an internal memo from Secretary Antony Blinken (leaked to me by an officer in the department’s Foreign Service) and circulated among employees last week, the answer might be yes.
The memo represents an effort by Secretary Blinken to carry out President Biden’s Executive Order 14075 from last June. That order instructs agencies of the federal government to do what they can to stop “conversion therapy” for “LGBTQI+” people. Following its release, Biden appointed Jessica Stern as Special Envoy to Advance the Human Rights of LGBTQI+ Persons, a position created by the Obama administration but left unfilled under Donald Trump. Stern, who goes by “all pronouns,” had previously served as executive director at OutRight Action International, an advocacy organization with a permanent presence at United Nations headquarters in New York. OutRight has borrowed arguments against “conversion therapy” for sexual orientation (where the evidence against the practice is strong) and applied them, unscientifically, to “gender identity” (where studies have consistently shown that cross-gender identification in children is, for the vast majority of those who experience it, a passing phase). This strategy of piggybacking off public ignorance about the difference between homosexuality and transgenderism is by now familiar. And lest it be thought that politicians know better, Biden himself seems unable to differentiate between sexual orientation and gender identity.
The Biden administration has defined “conversion therapy” as any effort to “suppress or change an individual’s . . . gender identity.” The Blinken memo cites as an authority the American Academy of Child and Adolescent Psychiatry, an organization that, like the American Academy of Pediatrics, has fallen victim to capture by a small but vocal and well-organized group of ideologues, among them Jack Turban. The memo relies on the United Nations Independent Expert on sexual orientation and gender identity, Victor Madrigal-Borloz, to clarify that “conversion” means only efforts to change a transgender identity into a “cisgender one.” Thus, a hypothetical scenario in which a child is put under intense pressure to become trans, even if this means medicalization, would technically not count as “conversion.” At the first signs of a child’s gender distress or confusion, the only legitimate, “human rights”-respecting outcome of treatment, according to the Biden administration, is social transition followed, in most cases, by body modification.
Predictably, the Blinken memo contains no evidence or arguments for its claims about “conversion therapy,” but instead defers to “every major medical and mental health association in the United States.” In fact, however, medical groups like the AAP and AACAP have not followed the science on this issue, instead allowing activists to dictate policy positions based on pseudoscientific claims, egregious mischaracterizations of available studies, and, in some cases, outright fabrications of data. Anyone with above-average intelligence, a basic grasp of scientific methods, and enough time and patience to master the literature on this issue will easily come to the same conclusion. Medical authorities in Sweden, Finland, and the U.K. have already done so, as has Florida. France and Australia may soon follow suit.
Ominously, the Blinken memo defines “conversion therapy” to include not only “electric shock” and “corrective rape” but also “talk therapy.” That’s right: using psychotherapy to help a child in distress about her changing body feel more comfortable in it rather than undergo expensive, risky, and irreversible hormonal and surgical interventions is, according to the State Department, no different from electrocuting gays and lesbians in order to “liberate” them from their innate sexual attractions.
The problem, for countries like Sweden, Finland, and the U.K., is that medical authorities in these places have concluded over the past two years that the evidence for pediatric “gender affirming care” is extremely weak and that, as a result, hormonal and surgical interventions are (as Finland’s COHERE put it) “experimental.” Sweden and Finland are now instructing clinicians who deal with minors to utilize an approach that emphasizes talk therapy as the first line of defense and “affirming” drugs only in extreme situations, if ever. Sweden has banned gender surgeries for minors—surgeries that are practiced in the United States, notwithstanding the repeated gaslighting of gender clinics and left-of-center media outlets.
The Blinken directive effectively turns American consulates and embassies into global “gender affirming” spies. Embassies are instructed to “submit robust information on the so-called ‘conversion therapy’ practices” of host countries “as part of the annual Human Rights Reports.” Jessica Stern’s office will then devise an “action plan to combat the practice across foreign policy and foreign assistance lines of effort.”
The harms from the new policy will be tangible. First, bullying countries into not providing talk therapy to youth in distress over their developing bodies will, if successful, harm gay youth. Gender nonconformity and associated distress are very common phases of gay and lesbian youth development, as confirmed by research, clinical experience, and many firsthand accounts. If not allowed to talk about their feelings, these teenagers will be pumped full of synthetic hormones; some will find themselves under the surgeon’s knife. In Iran, being gay is punishable by death, but the condemned can avoid this fate by agreeing to “sex change” procedures. It is a sad irony that under the new Biden-Blinken policy, the Ayatollahs’ attitude toward homosexuality is now considered more in line with human rights than Europe’s most progressive welfare states. The Biden administration’s manipulation of American public solicitude for gay people in the interest of radical gender policies is nothing short of cynical.
Second, making “gender affirming care” a foreign policy requirement will dilute the moral authority of America’s broader commitment to human rights. Are foreign leaders now to believe that China’s persecution of its Uyghur minority, Venezuela’s use of arbitrary detentions and torture against regime dissidents, and the Taliban’s systematic oppression of women and girls are all on par with, say, Sweden urging its psychologists to help kids feel comfortable in their own bodies? Transgender activists will argue that ending “conversion therapy” and pushing back against other state-sponsored abuses are not mutually exclusive, but of course they are—and pretending otherwise will empower critics of the United States to argue that our understanding of human rights is absurd.
Third, even taking at face value the Biden administration’s own goal of promoting the wellbeing of transgender-identified people, it is hard to see how the new directive accomplishes that. What happens when an impoverished Sudanese teenager begins hormone therapy or gets a mastectomy and serious complications arise, as they so often do for these procedures? Medical services in many developing countries are notoriously subpar, and if risk of serious complications from specialized and as-yet experimental hormonal and surgical interventions is high in the United States, that risk is compounded where transitioned minors have no access to specially trained doctors with adequate medical equipment. It’s hard to see how rushing kids to experimental gender transition in countries without proper medical infrastructure serves their health needs.
Further, for countries with deep suspicions toward the West—countries, in other words, likely to be the most intolerant of transgender-identified people—the association of cross-gender identification with American foreign policy enables traditionalists to frame social change as cultural imperialism. Even assuming, for the sake of argument, youth medical transgenderism is a worthy goal, it defies reason that American soft power can aptly promote it.
In line with Tip O’Neill’s famous observation that “all politics is local,” Biden’s order to the State Department and Secretary Blinken’s interpretation of that order are, in all likelihood, driven more by domestic political calculation than by strategic consideration about protecting human rights abroad. As Biden himself made clear at the time, EO 14075 was a response to Republican-held states passing laws like Florida’s Parental Rights in Education Act (mischaracterized as “Don’t Say Gay”) and various bans on pediatric medical transition. This development in American foreign policy is a sobering (if haphazard) example of policy expansion.
Other implications of the new “human rights” policy are anyone’s guess. Will the United States use its long financial arm to pressure Sweden, Finland, and the U.K. to restore “affirmative care,” against the judgment of experts in those countries that—unlike here—have conducted systemic evidentiary reviews? Will economic and cultural cooperation between the U.S. and other Western nations be made contingent on these countries demonstrating that a sufficient number of teenagers every year are medically transitioned? (Bureaucrats like to define objectives and measure outcomes numerically.) Or will the harm be largely symbolic and reputational, underscoring the extent to which American elites are willing to sacrifice reason and common sense to the ever-proliferating and increasingly destructive demands of wokeness?
In 2009, Barack Obama notoriously kicked off his presidency with an “apology tour” in which he lamented American “arrogance” in foreign policy. Speaking to the Muslim world from a podium in Cairo, Obama implied that “colonialism” was to blame for Muslim nations’ failings. The president assured his audience that “America does not presume to know what is best for everyone,” and that “it is important for Western countries to avoid impeding Muslim citizens from practicing religion as they see fit.” Under President Biden, it would appear that cultural arrogance and “colonialism” (as defined in the contemporary academy) are once again staples of American foreign policy.
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