By Mark W. Fowler

“Some ideas are so stupid that only intellectuals believe them.” —George Orwell

In a recent article in the AMA’s (American Medical Association) Journal of Ethics, the idea of research on the viability of uterine transplants to biological men was endorsed, including whether taxpayers should foot the bill for it.

Two parables come to mind: A scientist posits that frogs hear through their legs. To test this hypothesis, he trains frogs to jump on hearing a bell. Then, one by one he removes the frog’s legs until all four limbs are gone. Noting the absence of jumping activity, he proclaims that frogs without legs cannot hear. Regardless of how many times he replicates his result, his hypothesis is wrong. He has confused correlation with causality.

In Genesis Chapter 11, there is a passage warning against the hubris of man. Noting that men had arrogantly deigned to build a tower reaching to Heaven, the Lord confuses their language and scatters them as a reminder of and punishment for their arrogance and pride.

In a move reminiscent of medieval alchemist attempts to turn lead to gold, a subset of AMA leadership proposes funds to research transplanting uteruses from women to biological men. This will allow transgender women to “consolidate their identities” or perhaps even to gestate.

I am most sympathetic to those suffering from gender dysphoria. Many are troubled individuals with high rates of suicide, drug use, sex work, and estrangement from families. This delusional state is likely on the same continuum as body dysmorphic disorder, anorexia nervosa, and bulimia. It is a psychiatric illness, not a medical illness, and cognitive behavioral therapy or psychotherapy is likely more appropriate than surgery and hormones. It may be a form of social hysteria, as it has become more prevalent with the availability of social media.

It is worth noting that there are no FDA-approved medicines for surgery for this; few studies show it is significantly effective in reducing suicidality, and an increasing number of patients who have transitioned are having regrets and wish to detransition. In short, physicians are without sufficient knowledge to identify a scientifically justified course of therapy.

Activists in the field, many of whom are transgender or in a relationship with a transgender patient, have led the charge for gender-affirming care, calling those who desire a more studied approach haters or bigots — hardly the intellectual debate needed to clarify the issue. In the absence of clear scientific principles to guide them, physicians would do well to study the long-term effects of gender-affirming care before embracing it pell-mell.

The fact that several European countries have implemented limits on gender-affirming care (Finland, Sweden, and the United Kingdom) for minors is a tocsin that American physicians should heed. Can it really be argued that the mentioned countries are bigots or haters? Can it be that thoughtful physicians guided by the principle of “First, do no harm” are Luddites? Common sense would hold otherwise.

Those remembering the devastating medical mistakes such as Thalidomide and frontal lobotomy now seem justified in their opposition.

You can’t turn lead into gold. You can’t make a silk purse out of a sow’s ear. Whether you could actually implant a woman’s uterus in a man’s body is not the question. The question is whether you should, especially for so ephemeral a purpose as “consolidating a delusional identity.”

Mark W. Fowler is a board-certified physician and former attorney. He can be reached at [email protected].