• LGBTQ+ activists claim schools should affirm gender identity, create welcoming school cultures, and facilitate the transition process
  • North Carolina should resist the temptation to include gender identity in the Healthful Living and Science standards
  • Gender identity is not a proper topic to include in academic standards, however, and advocates ignore the unsettled science behind gender transitioning and the uncertain, long-term implications of such decisions

As the North Carolina Department of Public Instruction reviews the process for Healthful Living and Science academic standards, parents and policymakers on both sides of this controversy are asking: Should gender identity be incorporated into the standards to make schools more “inclusive and affirming”? 

The desire to incorporate gender identity into the standards is driven by assertions that the “science” on gender identity is settled and the current belief that the best way to address these concerns is to build a culture that affirms identity. The rationale behind it may be sympathetic. Nevertheless, a closer look at the uncertainty, growing public opposition, and long-term implications reveals that incorporating gender identity into Healthful Living Standards would be unwise. Let’s look at the reasons why. 

A Proper Topic for a Review of Academic Standards? 

Activists tell us North Carolina schools need a culture that is “trans-affirming” to address the deep physical and emotional needs of students with gender identity issues. While this concern may sound understandable, is it a proper use of the standards process? 

The term “gender identity” and “transgender” are not mentioned in North Carolina’s current state standards. For starters, issues associated with transgender youth are usually behavioral, psychological, or medical in origin. A look at the standards may give us insight. 

As outlined in the Internal Procedures Manual of the North Carolina Standards Course of Study set by the Division of Academic Standards:

The standards review, revision, and implementation process provides a comprehensive study of each content area organized by grade level, proficiency level, and/or course. 

The manual later states:

Each individual content area in the NCSCOS should communicate what students should know and be able to do as a result of instruction at each grade level or from a course. Content and skills that are not limited to a particular material or methodology but can be delivered through multiple approaches and materials should be described. Specific teaching strategies, materials, or other information should be explored in optional curriculum support documents rather than in the NCSCOS. 

These quotes emphasize that the review process is focused on a study of each academic content area by grade level, proficiency level, and course. The focus is on what students need to know or do at each grade level or from each course. Efforts to infuse gender identity into the review process are, by definition, a misuse of the standards review process. 

Advocates will say students with gender identity issues need to be affirmed in their gender identity, precisely because such students are at higher risk of suicide. The problem is that, while affirming is currently thought to be the best approach, the science surrounding the issues is in great conflict. Some studies question the methodology of studies attesting to higher suicide rates and raise concerns about the long-term medical and psychological risks of those who have undergone gender transitioning, and some suggest that, rather than helping prevent suicide, affirming practices may lead to higher rates of suicide.

Of course, gender identity is a topic that can be mentioned in curriculum or instructional materials. However, since the science behind gender identity is still controversial, speculative, and unsettled, there are compelling reasons why it should not be included in the Healthful Living Standards.  

Gender Affirming Culture: The Whole Picture 

In a recent piece in City Journal, Christopher F. Rufo noted some of the not-so-small issues that are often overlooked in the public schools’ quest to be an affirming community. Rufo cited a recent survey by Mental Health America that pointed out the relatively high rate of mental health disorders among transgender youth. It included a recent survey of 11- to 17-year-old transgender youths that found 93% were at risk of psychosis, 91% exhibited signs of posttraumatic stress disorder, 90% likely used drugs and alcohol, 90% experienced severe anxiety, and 95% experienced moderate to severe depression.  

Other results from the Trevor Project National Survey of LGBTQ Mental Health raise additional concerns. It found 42% of LGBTQ youth attempted suicide in the past year. Seventy percent of LGBTQ youth reported their mental health was “poor” most of the time or always during the Covid-19 pandemic.

These numbers are alarming. Rather than respectfully trying to address the source of these mental health issues, those seeking to affirm gender identity glamorize and uncritically promote transgender identity while seeking to shut down any criticism as discriminatory and bigoted. 

But this one-sided approach may do more harm than good. 

The Science Behind Gender Identity: Far from Settled 

Despite what advocates say, the science behind gender identity and dysphoria is far from settled. It’s only settled if you ignore the growing body of research that questions the current thinking that affirmation is the only response to address transgender conflict and dysphoria. There is no shortage of examples worth highlighting. 

Ryan Anderson’s excellent book, “When Harry Became Sally,” tells the story of how in the 1960s a young professor of psychiatry at Johns Hopkins named Paul McHugh opposed the idea that gender was a fluid concept. He also argued that hormones and surgery cannot transform a man into a woman or vice-versa. Sex reassignment surgeries were unsuccessful, and he thought the transitioning process a mistake. Later, as head of the psychiatry department at Hopkins, McHugh concluded that sex reassignment was bad medicine and, as he said, “fundamentally cooperating with mental illness.” Based on these conclusions Hopkins stopped prescribing gender-reassignment surgeries. 

McHugh’s evidence-based approach to gender dysphoria prevailed at Johns Hopkins for several decades. In 2016, however, the hospital announced it would start performing sex-reassignment procedures again. Had the science changed? No. Mounting political pressure by LGBTQ groups like LGBTQ Nation and the Human Rights Campaign took their toll. Gender identity was not part of the national discussion because of changing public attitudes or new developments in science, but because of successful campaigns by activist organizations. 

In a 2018 article, Dr. Kenneth J. Zucker, a worldwide expert on gender dysphoria based in Toronto, claimed that “parents who support, implement, or encourage a gender social transition (and clinicians who recommend one) are implementing a psychosocial treatment that will increase the odds of long-term persistence.” Zucker’s battle has been long. He has gone against the prevailing winds in the battle to address gender dysphoria. Ultimately, his views cost him his job

Zucker contends that the view of advocates that a child’s sense of identity is formed by messages from family, peers, and society is mistaken. 

Zucker believes that teachers, parents, friends, and societies that try to affirm an alternative identity reduce the chances that the individual will learn to adjust to his or her body. Instead of affirmation, Zucker has long recommended that parents or others help children to identify the underlying cause of their conflicts and successfully resolve them. 

Much of the argument to facilitate gender transitioning rests on the belief that those with gender identity issues have high rates of suicide that necessitate treatment and access to puberty blockers or hormones. Is that belief true? 

A recent article by Jay Greene of the Heritage Foundation challenged this contention. Greene found that the research supposedly supporting this assumption was lacking. Indeed, in a more rigorous study Greene found that easing access to puberty blockers and cross-sex hormones without parental consent actually increases suicide rates. 

Part II of this article will explore the internal contradictions of gender identity advocates and how affirming transgender rights has led to an erosion of parental rights.