"Those who can make you believe absurdities can make you commit atrocities,"
— Voltaire
Gender dysphoria is only the newest social and political pathology. Social and political pathologies are always generated by "mind viruses" and then enforced by vocal minorities who intimidate and ultimately overwhelm the majority — for a time — to accumulate wealth and power to themselves. Too many times, the damage is permanent.
Read Charles MacKay's 1842 masterpiece "Extraordinary Popular Delusions and the Madness of Crowds." Yes, 1842, that's not a type. Still relevant. Available in PDF online.
In his twelve volume "A Study of History" Arnold Toynbee observed that essentially no civilization had been overwhelmed outwith; they had all died from suicide. Yes, many armies and civil administrations have been overwhelmed, but civilizations die by suicide. Read James Burnham's 1964 classic "Suicide of the West" and Gad Saad's new book "Suicidal Empathy."
"Shall we expect some transatlantic military giant, to step the Ocean, and crush us at a blow? Never!…. All the armies of Europe, Asia and Africa combined, with all the treasure of the earth (our own excepted) in their military chest; with a Buonaparte for a commander, could not by force, take a drink from the Ohio, or make a track on the Blue Ridge, in a trial of a thousand years.
"At what point then is the approach of danger to be expected? I answer, if it ever reach us, it must spring up amongst us. It cannot come from abroad. If destruction be our lot, we must ourselves be its author and finisher. As a nation of freemen, we must live through all time, or die by suicide."
— Abraham Lincoln's address to the Young Men's Lyceum of Springfield, January 27, 1938.
But now, our destruction is coming from abroad, not as military destruction but as the internal destruction Lincoln warned. Read Peter Schweitzer's "The Invisible Coup." Why does Mexico have 52 consulates while Britain has only ten, and Canada only thirteen? Why are pregnant Chinese tourists in their 38th week permitted to give birth in Arcadia, to take their US Citizen children home, and demand to vote Communist in American elections in eighteen years?
"Eternal vigilance is the price of liberty."
— John Philpot Curran (1790), Thomas U. P. Charlton (1809), Wendell Phillips (1852)
As part of the journey on gender ideology as a social construct instead of just gender as a biological given, we should go back a bit further. In the 80's and 90's, it became vogue, legal, and accepted for women to take jobs from men who were more qualified. Because we were woefully unprepared to have a rational discussion about the absolute differences between males and females, we let the powers that be convince us that women should be able to lawfully and rightly take jobs that had previously been held by men. Those jobs had been previously held by men because the male is generally stronger, faster, more focused, and able to move big items with less stress than a female. We bought it hook, line, and sinker. Thus the EEOC and Affirmative Action machine was able to take over everything. I am aware that these ideologies include more than just gender, but let's limit this discussion to women and men in the workplace.
There are jobs that men are more generally suited to and some jobs women simply cannot do without some accommodation being made. Any military, first responder, construction, or other job that requires physical superiority (there, I said it!) should be filled by males. But we, in our infinite social engineering wisdom decided that not only could we not discuss the obvious differences in the male and female abilities in jobs requiring speed and strength, we could never, ever keep women out of these jobs because...but that is where the logic fell apart. There is not a because except for personal preference, the demand for the recognition of dreams (I've always wanted to be a fireman, etc.), and the inability to foresee consequences.
We have done a great disservice to our girls over the last six decades by telling them (without shame) that they can do anything they want to do. False. They can hold jobs they cannot do, but only through legal force and making the males around them pick up their slack. The job still must be done and it falls to the more skilled and capable in any group to get it done. Take a female police officer that cannot, and I mean cannot, chase down and subdue a suspect. If there are males around, and they are always called in for just this purpose, the female is relieved of the requirement to do her job because the men showed up and had to do it.
Take our military combat units. We send men into war to kill people and break things. However, again in our infinite social engineering wisdom, we decided that women should not be kept out of combat because it would affect her promotions as they are rightly based on combat experience. How much in just pure dollars has it taken us to care for the medical needs of the females we put into the military and whose bodies were simply not up to the lesser physical readiness standards than males? How much in just pure dollars have we spent in setting up the facilities for women in male-dominated outposts and camps because the girls simply had to go play soldier? Now for the big question: Is the military better for having put women in combat? Are those women better off? Are the men who lost promotions to women of lesser ability and performance better off? I say no on all fronts.
Decades ago, we did not have the ability to sort out gender issues and it resulted in our allowing millions of females to take jobs from their more-qualified male peers. Once we start allowing ideology to squash truth and open discussion, our trajectory takes us to bad places. Fifty years to now and we have a transgender ideology that still does not acknowledge the absolute differences between males and females, and that one cannot be the other. It is all part of the same inability to acknowledge simple, yet absolute truths. The inability to even discuss controversial topics tells one just how much they fear truth.
My son conjectured decades ago that "women's equality" is the reason one income cannot support a family. When agitators demanded and got "equal pay for equal work" in places where equal work was physically impossible, men's pay had to be reduced because a unit of production has a fixed economic value, no matter who does it.
I would say that females should be allowed to do jobs that require physical attributes (e.g. lifting a certain weight), if they can demonstrate that they can do it — as some can.
Give some thought to writing a substack piece about this as a guest for me.
The article frames the collapse of pediatric gender medicine primarily as a “preference cascade” problem — an orthodoxy sustained by social pressure, institutional conformity, and fear of dissent until enough cracks appeared to make skepticism publicly safe again. That’s part of the story. But it badly underestimates the most important stabilizing force in the system:
follow the money.
The surgeries are enormously expensive. The hormones and blockers often continue indefinitely. The counseling, monitoring, revisions, fertility interventions, and complications can extend for years. In economic terms, this is not a one-time treatment model. It is recurring revenue.
And once these procedures receive moral endorsement from elite institutions — “lifesaving,” “medically necessary,” “affirming care” — the political pressure to publicly finance them becomes intense. Insurance companies are pushed to cover them. Medicaid is pushed to cover them. State systems are pushed to cover them. Employers are pressured to include them. The public spigot opens.
At that point, the incentives become self-reinforcing.
Hospitals build departments around the practice. Medical schools create training pathways. Pharmaceutical companies benefit from long-term hormone dependency. Activist organizations gain fundraising leverage. Professional associations acquire ideological and reputational investment in the model. Entire institutional ecosystems become financially and politically committed to its continuation.
That is why the “consensus” became so aggressively defended.
The article treats the phenomenon mostly as a psychological and sociological event — people afraid to dissent from elite opinion. But elite opinion itself often follows institutional incentives. Once a treatment pathway becomes financially embedded inside major medical systems, dissent threatens not merely reputations but revenue streams, grant structures, legal exposure, staffing, and institutional prestige.
In that sense, the system behaves less like a scientific enterprise and more like a protected market.
And protected markets are notoriously resistant to self-correction.
That helps explain why weak evidence could coexist with such extraordinary certainty. Normally, medicine proceeds cautiously when long-term evidence is sparse, especially for irreversible interventions on minors. But here caution was often replaced with moral absolutism. Skepticism itself became evidence of bad character. That is usually a warning sign that something other than science is stabilizing the consensus.
The article correctly notes that once malpractice verdicts appear and medical associations begin retreating, the entire structure can unwind quickly. But again, the real pressure point may not be ideological at all.
It may be actuarial.
The moment insurers begin viewing these procedures as high-liability medicine rather than protected medicine, the economics change dramatically. Hospitals suddenly face litigation risk. Carriers reassess exposure. Public systems reconsider reimbursement. The same institutions that once moved in lockstep toward expansion can begin moving in lockstep toward retreat.
And that is the uncomfortable possibility hanging over this debate: if the medical consensus crumbles, what follows is not merely cultural embarrassment. It is potentially a financial calamity for institutions that expanded aggressively into a treatment model now facing mounting legal, scientific, and public scrutiny.
The article sees a preference cascade. Fair enough.
But preference cascades alone do not sustain billion-dollar medical ecosystems.
"Those who can make you believe absurdities can make you commit atrocities,"
— Voltaire
Gender dysphoria is only the newest social and political pathology. Social and political pathologies are always generated by "mind viruses" and then enforced by vocal minorities who intimidate and ultimately overwhelm the majority — for a time — to accumulate wealth and power to themselves. Too many times, the damage is permanent.
Read Charles MacKay's 1842 masterpiece "Extraordinary Popular Delusions and the Madness of Crowds." Yes, 1842, that's not a type. Still relevant. Available in PDF online.
In his twelve volume "A Study of History" Arnold Toynbee observed that essentially no civilization had been overwhelmed outwith; they had all died from suicide. Yes, many armies and civil administrations have been overwhelmed, but civilizations die by suicide. Read James Burnham's 1964 classic "Suicide of the West" and Gad Saad's new book "Suicidal Empathy."
"Shall we expect some transatlantic military giant, to step the Ocean, and crush us at a blow? Never!…. All the armies of Europe, Asia and Africa combined, with all the treasure of the earth (our own excepted) in their military chest; with a Buonaparte for a commander, could not by force, take a drink from the Ohio, or make a track on the Blue Ridge, in a trial of a thousand years.
"At what point then is the approach of danger to be expected? I answer, if it ever reach us, it must spring up amongst us. It cannot come from abroad. If destruction be our lot, we must ourselves be its author and finisher. As a nation of freemen, we must live through all time, or die by suicide."
— Abraham Lincoln's address to the Young Men's Lyceum of Springfield, January 27, 1938.
But now, our destruction is coming from abroad, not as military destruction but as the internal destruction Lincoln warned. Read Peter Schweitzer's "The Invisible Coup." Why does Mexico have 52 consulates while Britain has only ten, and Canada only thirteen? Why are pregnant Chinese tourists in their 38th week permitted to give birth in Arcadia, to take their US Citizen children home, and demand to vote Communist in American elections in eighteen years?
"Eternal vigilance is the price of liberty."
— John Philpot Curran (1790), Thomas U. P. Charlton (1809), Wendell Phillips (1852)
Van: TY. I have quoted Lincoln's Lyceum speech multiple times — including in prior Substack commentaries. He is one of my few idols...
As part of the journey on gender ideology as a social construct instead of just gender as a biological given, we should go back a bit further. In the 80's and 90's, it became vogue, legal, and accepted for women to take jobs from men who were more qualified. Because we were woefully unprepared to have a rational discussion about the absolute differences between males and females, we let the powers that be convince us that women should be able to lawfully and rightly take jobs that had previously been held by men. Those jobs had been previously held by men because the male is generally stronger, faster, more focused, and able to move big items with less stress than a female. We bought it hook, line, and sinker. Thus the EEOC and Affirmative Action machine was able to take over everything. I am aware that these ideologies include more than just gender, but let's limit this discussion to women and men in the workplace.
There are jobs that men are more generally suited to and some jobs women simply cannot do without some accommodation being made. Any military, first responder, construction, or other job that requires physical superiority (there, I said it!) should be filled by males. But we, in our infinite social engineering wisdom decided that not only could we not discuss the obvious differences in the male and female abilities in jobs requiring speed and strength, we could never, ever keep women out of these jobs because...but that is where the logic fell apart. There is not a because except for personal preference, the demand for the recognition of dreams (I've always wanted to be a fireman, etc.), and the inability to foresee consequences.
We have done a great disservice to our girls over the last six decades by telling them (without shame) that they can do anything they want to do. False. They can hold jobs they cannot do, but only through legal force and making the males around them pick up their slack. The job still must be done and it falls to the more skilled and capable in any group to get it done. Take a female police officer that cannot, and I mean cannot, chase down and subdue a suspect. If there are males around, and they are always called in for just this purpose, the female is relieved of the requirement to do her job because the men showed up and had to do it.
Take our military combat units. We send men into war to kill people and break things. However, again in our infinite social engineering wisdom, we decided that women should not be kept out of combat because it would affect her promotions as they are rightly based on combat experience. How much in just pure dollars has it taken us to care for the medical needs of the females we put into the military and whose bodies were simply not up to the lesser physical readiness standards than males? How much in just pure dollars have we spent in setting up the facilities for women in male-dominated outposts and camps because the girls simply had to go play soldier? Now for the big question: Is the military better for having put women in combat? Are those women better off? Are the men who lost promotions to women of lesser ability and performance better off? I say no on all fronts.
Decades ago, we did not have the ability to sort out gender issues and it resulted in our allowing millions of females to take jobs from their more-qualified male peers. Once we start allowing ideology to squash truth and open discussion, our trajectory takes us to bad places. Fifty years to now and we have a transgender ideology that still does not acknowledge the absolute differences between males and females, and that one cannot be the other. It is all part of the same inability to acknowledge simple, yet absolute truths. The inability to even discuss controversial topics tells one just how much they fear truth.
My son conjectured decades ago that "women's equality" is the reason one income cannot support a family. When agitators demanded and got "equal pay for equal work" in places where equal work was physically impossible, men's pay had to be reduced because a unit of production has a fixed economic value, no matter who does it.
Laura: Thank you for a fine commentary.
I would say that females should be allowed to do jobs that require physical attributes (e.g. lifting a certain weight), if they can demonstrate that they can do it — as some can.
Give some thought to writing a substack piece about this as a guest for me.
The article frames the collapse of pediatric gender medicine primarily as a “preference cascade” problem — an orthodoxy sustained by social pressure, institutional conformity, and fear of dissent until enough cracks appeared to make skepticism publicly safe again. That’s part of the story. But it badly underestimates the most important stabilizing force in the system:
follow the money.
The surgeries are enormously expensive. The hormones and blockers often continue indefinitely. The counseling, monitoring, revisions, fertility interventions, and complications can extend for years. In economic terms, this is not a one-time treatment model. It is recurring revenue.
And once these procedures receive moral endorsement from elite institutions — “lifesaving,” “medically necessary,” “affirming care” — the political pressure to publicly finance them becomes intense. Insurance companies are pushed to cover them. Medicaid is pushed to cover them. State systems are pushed to cover them. Employers are pressured to include them. The public spigot opens.
At that point, the incentives become self-reinforcing.
Hospitals build departments around the practice. Medical schools create training pathways. Pharmaceutical companies benefit from long-term hormone dependency. Activist organizations gain fundraising leverage. Professional associations acquire ideological and reputational investment in the model. Entire institutional ecosystems become financially and politically committed to its continuation.
That is why the “consensus” became so aggressively defended.
The article treats the phenomenon mostly as a psychological and sociological event — people afraid to dissent from elite opinion. But elite opinion itself often follows institutional incentives. Once a treatment pathway becomes financially embedded inside major medical systems, dissent threatens not merely reputations but revenue streams, grant structures, legal exposure, staffing, and institutional prestige.
In that sense, the system behaves less like a scientific enterprise and more like a protected market.
And protected markets are notoriously resistant to self-correction.
That helps explain why weak evidence could coexist with such extraordinary certainty. Normally, medicine proceeds cautiously when long-term evidence is sparse, especially for irreversible interventions on minors. But here caution was often replaced with moral absolutism. Skepticism itself became evidence of bad character. That is usually a warning sign that something other than science is stabilizing the consensus.
The article correctly notes that once malpractice verdicts appear and medical associations begin retreating, the entire structure can unwind quickly. But again, the real pressure point may not be ideological at all.
It may be actuarial.
The moment insurers begin viewing these procedures as high-liability medicine rather than protected medicine, the economics change dramatically. Hospitals suddenly face litigation risk. Carriers reassess exposure. Public systems reconsider reimbursement. The same institutions that once moved in lockstep toward expansion can begin moving in lockstep toward retreat.
And that is the uncomfortable possibility hanging over this debate: if the medical consensus crumbles, what follows is not merely cultural embarrassment. It is potentially a financial calamity for institutions that expanded aggressively into a treatment model now facing mounting legal, scientific, and public scrutiny.
The article sees a preference cascade. Fair enough.
But preference cascades alone do not sustain billion-dollar medical ecosystems.
Money does.
Jim: TY. You make a good case for the economic driver of such absurdities.