“Transgender” is a real thing. Including an actual medical condition, “gender dysphoria.” This is how Karl Bryant in the Encyclopedia Britannica defines it in signature sober Britannica style:
gender dysphoria (GD), formal diagnosis given by mental health professionals to people who experience distress because of a significant incongruence between the gender with which they personally identify and the gender with which they were born. The GD diagnosis appears in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; 2013), the American Psychiatric Association’s (APA’s) official listing of psychiatric disorders. A clinical description of GID also appears in the World Health Organization’s (WHO’s) International Statistical Classification of Diseases and Related Health Problems (ICD-10; 1992). (The ICD-10 does not use the term gender dysphoria.) Although the diagnosis of GD is usually made by mental health care providers, much of the treatment for adults is endocrinological and surgical in nature and often follows World Professional Association for Transgender Health’s Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (2012). (1)He goes on to stress: “Although gender nonconformity is not a mental disorder, GD is characterized by clinically significant mental anguish.”
And he notes, “With the development of successful surgical techniques and hormone replacement therapy, several thousand transsexual adults with persistent GD [gender dysphoria] have undergone a permanent gender reassignment.” Unfortunately, he doesn’t specify how much of the world is included in those “several thousand” who have undergone gender-reassignment surgery. Even if all of them were in the US, physical gender-reassignment surgery is hardly part of the everyday routine. People who don’t want to be conned by dishonest bigots should actually try to keep a sense of proportion.
Analysts from UCLA found in 2025: “More than 2.8 million people now identify as transgender in the US, including an estimated 724,000 youth, according to a new data analysis that is the largest of its kind to date.” (2)
In other words, it’s not as widespread as the common cold. But it’s also not just some fad among people who Republicans considered to be weirdos. It needs to be seen as a real condition, not some fantasy in the heads of mean-spirited authoritarian types.
And, not surprisingly, there are legitimate controversies around gender aphasia and sex-tradition care – and by “legitimate” I do not mean hate-mongering nonsense from rightwing polemicists: “Although the revisions to DSM-5 have assuaged some criticism, it has been argued that the diagnosis of GD mistakenly categorizes a medical condition as a mental health disorder. These critics often point to recent research that may indicate a biological basis for transsexuality.”
The Mayo Clinic also has a website with basic information on gender dysphoria. (3)
Medical research has long since recognized that gender is more complicated than “boys are boys” and “girls are girls.” In Western science, Havelock Ellis (1859-1939) and Sigmund Freud (1856-1939) were critically examining conventional assumptions about sexuality and recognizing that conventional heterosexuality is not a uniformly “normal” and healthy state for people.
How is the Trump movement, aka, the Republican Party, using the issue? Here’s how the Orange Anomaly himself has been using it, here in 2024 during the last Presidential race:
“No transgender, no operations — you know, they take your kid — there are some places, your boy leaves for school, comes back a girl. Okay? Without parental consent.” He added, “At first, when I was told that was actually happening, I said, you know, it’s an exaggeration. No: it happens. It happens. There are areas where it happens.” (4)This is a classic cult-like formulation. Sex-adjustment operations are a lot more complicated than going to the clinic to have a mole removed or a routine physical. Anyone with a minimal knowledge of gender-adjustment treatment knows it’s a lie that it can be done in a single day. No school district in the United States – or any other country I know of – can decide to send a student to a surgeon for a quickie sex change operation. In many school districts, the school nurse can’t even give a student an aspirin without parental consent.
There may some Trump cult followers who really are dim enough to believe what Trump says. But even I, with low expectations about the cognitive abilities of Trump cultists, find that hard to believe. He’s lying on this. (Like on so many other things.) And essentially all his supporters know he’s lying about it. But it’s a sign of loyalty to pretend they believe it. And even to repeat it.
Know-Nothing hysteria about real gender-related issues is harmful to real people and if often deeply mean-spirited. For the Trump cult, being mean-spirited is part of their identity. (5)
“Gender” is not equivalent to reproductive biology. There are a number of societies past and present that recognize more than two genders. (6) And, as the pioneering American feminist Margaret Fuller said in her 1845 Woman in the Nineteenth Century put it, “Male and female represent the two sides of the great radical dualism. But, in fact, they are perpetually passing into one another. Fluid hardens to solid, solid rushes to fluid. There is no wholly masculine man, no purely feminine woman.” [my emphasis]
Ideas Democrats should consider in countering Republican demagoguery on “the trans”
- Call out cult-like lies on the issue from Republicans.
- Start using the medical term “gender dysphoria” to remind people that we’re talking about a real medical condition here.
- Straightforwardly slap down superficial slogans like “boys playing in girls’ sports,” which even Gavin Newsom has adopted.
- Since the Republicans and the occasional Democratic empty suit will keep yammering about “the trans” for Lord-knows-how-long, use it also as an opportunity to talk about the real issue of “gender dysphoria” a shame the Republicans for promoting petty bigotry over a rare but serious real medical condition.
- Remember that for American voters with the slightest willingness or inclination to vote for Democrats, “be a decent person” is still an appealing concept.
- Adopt Tim Walz’ 2024 label for Republicans as “weird” over their obsession with “the trans” and slogans like Trump saying the Democrats want “transgender for everybody.”
(1) Bryant, Karl. "gender dysphoria". Encyclopedia Britannica 05/18/2026. <https://www.britannica.com/science/gender-dysphoria> Accessed 23 May 2026.
(2) Levin, Sam (2025): More than 2.8m people in US identify as trans, including 724,000 youth, data shows. Guardian 08/20/2025. <https://www.theguardian.com/world/2025/aug/20/trans-people-us-data> (Accessed: 2026-23-05).
(3) Gender dysphoria. Mayo Clinic 01/01/2025. <https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/diagnosis-treatment/drc-20475262> (Accessed: 2026-23-05).
(4) Dale, Daniel (2024): Fact check: Trump revives his lie that schools are secretly sending children for gender-affirming surgeries. CNN Politics 10/26/2024. <https://edition.cnn.com/2024/10/26/politics/fact-check-trump-rogan-children-gender-affirming-surgeries> (Accessed: 2026-23-05).
(5) Boerner, Heather (2022): What the Science on Gender-Affirming Care for Transgender Kids Really Shows. Scientific American 05/12/2022. <https://www.scientificamerican.com/video/what-the-science-on-gender-affirming-care-for-transgender-kids-really-shows/> (Accessed: 2026-23-05).
How Junk Science is Being Used Against Trans Kids. Scientific American YouTube channel 04/09/2026. <https://youtu.be/GOIWyP5uqgM?si=4OMT_90XcOeGBvn2> (Accessed: 2026-23-05).
(6) Britannica Editors. 6 Cultures That Recognize More than Two Genders. Encyclopedia Britannica 06/13/2025. <https://www.britannica.com/list/6-cultures-that-recognize-more-than-two-genders> (Accessed: 2026-23-05).
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