The Path to Dystopia is Paved with Ideology

Treating "gender distress" as something caused by a societal injustice is an attempt to normalize a condition and behaviors that have been considered unhealthy for millennia.

Early this year, a former BBC reporter named Hannah Barnes published a book called Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children. It describes the process by which an agency connected with the National Health Service in Great Britain went all in on the ideology of gender and promoted the early use of puberty blocking medication for thousands of young people. This eventually ended in a scandal and the decision of the National Health Service to discontinue the Gender Identity Development Service, known by its initials GIDS, in July of 2022.

Tavistock Trust (the parent agency) was originally about therapeutic psychoanalysis, but through GIDS it became known as practically an intake service for the gender transitioning of young people. These children and adolescents suffering from gender “distress” were set on a path to medication blocking puberty and subsequent cross-sex hormonal drug therapy. This was followed, for many, by surgical interventions that would strike most of us as appalling. The agency itself never knew how many of its clients went on to surgery to change their bodies from male to female or, more frequently, female to male, because it never did follow-up studies.

Time to Think tells an appalling story—or, in the words on its book jacket—“a disturbing and gripping parable for our times.” The history of GIDS demonstrates how the pressure of ideology determined a medical approach to some serious mental health issues that deserved much more therapeutic intervention.

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Barnes studied the bulky documentation of the controversy about GIDS and did exhaustive interviews with personnel involved in its work, as well as some of the people subjected to its treatment. The whole enterprise was compromised both by “political” and ideological pressures. While the writer says that she did not perceive most of the GIDS staffers as “ideologues,” her research actually gives evidence that the protocols and the actual work they did was informed by ideological constructs.

One executive said that the service was “a justice project as well as a therapeutic project.” This “justice-based approach extends to the demand that all gender-diverse people, including the young, should have the unquestionable right to make fully autonomous treatment decisions—the full freedom, we might say, to make their own mistakes.” Gender transitioning was about “potentially life-enhancing treatment.”

The problem starts with the concept “gender-diverse.” Treating a disorder as distress caused by a societal injustice attempts the normalization of a condition and behaviors that have been considered unhealthy for millennia. Even using the words gender dysphoria instead of the older “gender identity disorder” has an ideological tint. The staffers might not have been ideologues, but they were much aware of ideological pressure. When there was a scandal about the poor record keeping and research data kept in GIDS one of the grunt workers of the agency said, 

The Executive had found time to write papers about “postmodernist,” high-level theoretical ideas and stuff…We don’t [expletive deleted] care about post-structural ideas, in the end so many of us were saying we want to know some numbers, some actual numbers. How many?

A justice on Britain’s High Court was shocked that GIDS had no idea of what had happened to the thousands they had sent on to puberty blockers and medical and surgical interventions. Professionals in social work and psychology were dismayed at how the referrals to endocrinologists for hormonal therapy did not take into account the subjects’ comorbidity.

Many of the clients suffered from autism. A great number came from dysfunctional family systems. Some of the counselors themselves wondered if the transgender “distress” was really about trauma and fears about same sex attraction and sexual orientation. Eating disorders, suicidal ideation and attempts, rage, antisocial behavior, and histories of abuse were often ignored.

One counselor, just learning the ropes of her new job, recounted that while one of her first patients was a young person definitely suffering painful gender incongruence, he also had serious psychiatric comorbidity. This individual claimed to have three distinct personalities, including one that identified and tried to speak as Australian (with no history or connection to that part of the world), had auditory hallucinations, and yet was routinely referred to puberty blocking treatment after a few visits with counselors. 

Cases of bipolar clients, of patients who claimed ethnic identities completely different from their own, people who really needed therapeutic treatment, were pushed through the referral process to physical solutions to their anxiety about their bodies. All that was important was evidence of gender incongruence. Also ignored in the process of assessment was the fact that some consequences of gender blockers are irreversible, something scientists were late in discovering. Counselors presented the puberty blockers as a means of giving young people “time to think,” hence the ironic title of the exposé.  Counselors presented the puberty blockers as a means of giving young people “time to think.”Tweet This

Tavistock, under previous administrations and regimens, had been criticized for treating people with same sex attractions with the goal of having them overcome them—before the “dawn” of the liberalization of medical and societal attitudes about homosexuality as being “homophobic.” That label was now shelved for a more potent shibboleth, “transphobic.” 

Ironically, some homosexual counselors were cautioned about being transphobic because they thought that some clients and their parents preferred changing their birth gender—even with all it entailed of medication for the rest of their lives, infertility, and surgeries—to acknowledging homosexuality. One such counselor was criticized for mentioning “natal female” and “natal male” in describing patients. It was more correct, he was told, to say “assigned female or male gender at birth.” His objection to that formula led him to use “male-bodied and female-bodied,” but that was also frowned upon, apparently.

It seems, besides the condition of autism, distress about sexual orientation was associated with a good number of people who identified themselves as “trans.” One survey of the “transitioned” who had later “detransitioned” (returned to their natal sex) revealed that almost a fourth of those consulted said that “homophobia or difficulty accepting themselves as lesbian, gay or bisexual had been a reason for transition and subsequent detransition.” (An interesting indicator of how unready our society is for the gender bender crisis: British law at present does not allow those who legally changed their sex to change it back to their original one. That is because the law that allows the change is only for those who experience dysphoria. It does not recognize double jeopardy dysphoria, so you can’t go back to what you left behind.)

The comorbidity of the patients is the mirror image of the disorientation of the professionals who were supposed to help them. One of the clients of GIDS sued the agency in court and gave this painful testimony:

I am a twenty-two-year-old woman left with no breasts, a deep voice, body hair, a beard, affected sexual function and who knows what else that has not yet been discovered…I made a brash decision as a teenager (as a lot of teenagers do) trying to find confidence and happiness, except now the rest of my life will be negatively affected…I cannot reverse any of the physical, mental and legal changes that I went through. Transitioning was a very temporary, superficial fix for a very complex identity issue.

Another indication of the ideological underpinning of the gender transitioning “service” that was GIDS mission was the influence of NGOs and so-called “charities” which were really pressure groups of trans activists. These same parties, including one institution called Mermaids and another called Gender Intelligence were participants in GIDS events and were also partially responsible for the YouTube and TikTok posts and the trans web pages that, practically speaking, groomed adolescents for trans identities.

Aldous Huxley could not invent the dysfunction that we witness in the whole transgender pathology. We have a much braver new world than the dystopia he envisioned. What is frightening is the cowardly and ignorant response of some Church leaders. Catholic academics were once considered leaders of our faith community. Now they join forces with unhealthy and macabre movements. They should read Time to Think. We must do all we can to make them do so.


  • Msgr. Richard C. Antall

    Monsignor Antall is pastor of Holy Name Parish in the Diocese of Cleveland. He is the author of The X-Mass Files (Atmosphere Press, 2021), and The Wedding (Lambing Press, 2019).

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