The obstacles presented by ideology in discussing trans issues

With kind permission from the author of the thoughtful blog ThirdWayTrans, I am reposting one of his entries here.

ThirdWayTrans describes his blog as “Alternate ways to think about gender dysphoria, gender identity, retransition, detransition and transgender issues from a former trans woman and psychology grad student.”


By ThirdWayTrans

One thing that makes discussion of trans issues very difficult is that it that it lies at the intersection of ideology and truth. Science strives to seek truth and to be ideology-free. It can never meet this goal because it is done by humans who are incapable of being ideology-free. Still, it is the best method we have for minimizing the effects of bias and trying to get at an accurate picture of the world.

Jonathan Hadit, who is one of my favorite psychological writers, studies moral reasoning. He wrote an excellent book about it called The Righteous Mind. One of the things he talks about is that people have certain values that they hold sacred. He talks about the ideological differences between liberals and conservatives as being largely due to the fact that they hold different values sacred. When the tribal values are threatened people are far more concerned with neutralizing the threat then what is true or not. These sacred beliefs essentially become religious beliefs and anything that challenges them feels like heresy.

This is just part of the natural condition of humanity, and the same people that can be very capable of reason and nuance about questions that do not concern their sacred values suddenly become incapable of it when they do. I remember having a co-worker who was a decent programmer. He was also a Scientologist, and would occasionally talk about how “L. Ron Hubbard was an incarnation of the Buddha, and a messiah” or other Scientology related topics. I found it perplexing that he could have the logical chops necessary to be a good programmer and simultaneously be a Scientologist, but once beliefs acquire a religious character they are immune to logic. It is much the same with political ideologies.

One of the other things Hadit talks about is the importance of diversity of ideologies in creating good science. Scientists, like all people have ideologies and sacred beliefs. Scientists are often quite passionate about their theories. They are far from neutral, disinterested observers. So, any one scientist runs the risk of having their bias interfere with their observations. Science has tools for neutralizing bias from double-blind studies to peer review. Peer review relies on other scientists looking over the science, but they too have biases. If you have an ideologically diverse set of scientists then the effect of their biases are minimized. However, to the degree that they are not ideological diverse, groupthink and other phenomena can prevail. This effect is increased if the scientific study in question contradicts the sacred tribal values of that particular group of scientists.

In the therapy world we are also concerned with the biases of therapist interfering with the therapy and making it hard to see the client clearly. This phenomenon is called countertransference, which is where the therapist projects their own stuff onto the client and does not see the client clearly. Being aware of this is a start, but therapists are people too and are often blind to their own biases and personal hooks. One way to counteract this is through consultation groups, to get the opinions of others who do not have the same biases that you do, and therefore can see things clearly that you can’t see. However, if the therapists in the group share the same ideological beliefs and biases, then this does not help, and can even make things worse as phenomena such as groupthink take over.

Having a strong conviction that the “other side” is absolutely wrong about everything is a sure sign of being engaged in tribal thinking. The truth is messy and cuts across ideologies. It can be very difficult to let go of tribal thinking as it gives a sense of belonging, which is a primal need. If one does commit to the truth wherever it leads you, you are likely to be denounced by all ideological tribes. That can be a very lonely path. Speaking out for truth that goes against your tribal values is very difficult. I recently read Alice Dreger’s excellent bookGalileo’s Middle Finger where she talks about the conflict between truth and activism. Indeed, Dreger, as someone committed to truth over ideology, is often denounced for both being a “crazy liberal” and “neo-reactionary conservative”. I once read two articles denouncing her in these opposite ways within 10 minutes of each other.

The community of psychologists and therapists is far from ideologically diverse. Hadit, who is a social psychologist, gave a talk to a group of around one thousand social psychologists and asked them how many identified themselves as conservative or moderate. As described in this article in the New Yorker,
only 20 or so identified as centrist and only 3 identified as conservative. There might have been more conservatives that feared the career ramifications of openly identifying themselves as conservative. Further research in the article confirms that 37.5% of those social psychologists surveyed would be less likely to hire a conservative colleague, so their feelings would be entirely justified. This article describes social psychologists specifically, but similar phenomena exist with clinical psychologists, social workers and other mental health professionals.

I have come to the reluctant conclusion that it is progressive ideology itself that is the one of the things that gets makes it difficult to work on these issues. As a life-long liberal, and former card-carrying member of the ACLU back when that was a thing, it has been tough to come to that realization. I have long considered liberals to be my tribe and to see this ideology as itself being a problem makes me feel like I am without a tribe. However, since tribalism itself is the issue, perhaps that is a good thing. I want to emphasize that all ideologies get in the way of seeing the world clearly, it is just that the particular ideology that dominates the psychological profession is on the left. In particular, the following aspects of progressive ideology, particularly the specific progressive ideology of the psychological profession come in to play:

Privilege / Power Dynamics

Progressive ideology views the world in terms of privilege and power dynamics. People are divided into privileged and marginalized people across various axes. Why this is relevant is that is trans people are seen as a marginalized class while cis people are seen as a privileged class. This brings in to play various aspects of progressive ideology which is concerned with equalizing power dynamics. Indeed, helping marginalized people have a voice is a noble goal, however sometimes this ideology can cause harm to the very people it is trying to support.

One for the related ideas is that a marginalized class has been silenced and it is important that their voices be heard, particularly about their own experience. The privileged class is deemed to not understand the experience of the marginalized class and should listen to them. This is indeed true, and there is a long history of medicine centering men and treating women as afterthoughts and other examples of only paying attention to the dominant class. So it is indeed good and important for trans voices to be heard about their own experience.

However, this ideology leads to trans narratives being taken at face value by clinicians, and digging underneath them to be seen as being against the tribal values of the clinicians working on these issues. This is a well-meaning attempt to bring social justice to the marginalized people.

However, digging underneath things can be very important. Psychology is full of ideas about how people have defenses, self-serving rationalizations and all kinds of ways in which they don’t necessarily understand their own motivations. This is just as true whether someone is privileged or marginalized, and to ignore this when working with marginalized people is to do them a disservice. Indeed it is giving them lesser care, than you give to privileged people.

Primacy of narrative / lived experience

Another part of this ideology is the primacy of narrative and lived experience. This means the subjective is more important than the objective, and that lived experience trumps scientific research. This goes triple when it intersects with the ideas of privilege/oppresion referenced above. This is another idea that has good roots but can be taken too far. Narratives and lived experience are indeed important. As a therapist it is important to bracket aside theory and make sure that you are not treating a client as an object, or a theoretical construct and seeing the person as an individual. People are messy and do not fit cleanly into boxes.

However, the theoretical constructs and scientific research matter also. There is a vast deal of difference in degree of scientific orientation among psychologists and therapists. One problem in psychology is that the academic community of research psychologists and the community of clinicians and therapists often don’t talk to each other. Some sections of the the clinical community are even actively anti-science. Some professors in my master’s program would use the term “evidence-based practice” almost as a swear word, like it meant un-evolved. The narrative is not the only thing that matters.

Nothing is pathological

Progressives are absolutely allergic to the idea of pathology and tend towards the idea that calling anything pathology is “stigmatizing”. So there are movements to talk about how everything from bipolar to schizophrenia is a healthy variation of human experience. Many even question the very idea of mental illness. They are quite correct that stigmazing causes harm. I think it is harmful to stigmatize people based on their conditions, however we should never lose track that some things are healthier than others. For me the question of whether something is healthy is not whether it is normal but rather whether it is functional. Even being functional in some environments is sufficient, that is just a matter of getting to the right environment.

I recently read the excellent book Buddha and the Borderline by Kiera Van Gelder. This book tells of a woman’s journey in healing from borderline personality disorder. She describes how much of her community as well as many of those therapists and psychologists that treated her did not want to give her the borderline label for the reason that it would be stigmatizing. She acknowledges that it can indeed be stigmatizing when she is labeled borderline by others, but it it is also helpful to acknowledge it as an illness and that helps her in working with it.

I think refusing to understand that there is a such thing as health and a such thing as pathology causes problems, especially if you are in a profession where you are supposed to be an agent of health. Pathology should not be mistaken for diversity.

The insider experience is the only one that matters

Progressive ideology centers the insider experience, and holds that the words of a member of a group are those that are valid about a group. For example, only trans people should speak about trans experience, only women should speak about women’s experience, only black people should speak about black experience etc. It is indeed quite true that people that don’t have a certain experience are likely to get things wrong about that experience. Women are likely to see things about their experience that men don’t see, etc. Problems arise when the people studying something are all of one group and they are studying a different group. This idea also intersects with the idea of priviledge/power, and so applies in a much larger way when it is a privileged class studying a marginalized class.

This is an important idea, and tremendous harm has been caused by the lack of representation of minority groups in health. It is a very good thing that their voices are being heard in respect to their own health. However, while it is true that the insider can see what the outsider cannot see, it is also true that the outsider can see what the insider cannot see. Fish can’t see water. How many times have you encountered someone who had some false idea about themselves that everyone but they could see? This is precisely why the outsider perspective is important also. It is best to see something from as many perspectives as possible. All groups whether marginalized or privileged are prone to cultural blind spots and groupthink. Particularly in the case of groupthink, an outsider perspective is precisely what is needed.


I have written quite a bit about my views on identity here, and here The identity politics wing of progressivism strongly encourages a focus on identity, both the importance of personal identity and an identification with particular groups and classes. In addition to the critiques I made earlier, one problem with identiarianism is that it exacerbates the kind of tribal thinking that clouds truth. Once people feel their group is threatened they focus on defending their group rather than truth. This is just hard-wired into human psychology.


The nature of tribalism, identity and ideology increase the difficultly of find scientific truth on trans issues. The tense nature of these discussions drive away many people who might be interested in working on these issues, and also causes harm to trans people, as they are deprived of scientific advances and the best possible care. Understanding these effects and working towards minimizing them can help to reduce the tension in the ongoing discussion and help us work towards a future where all those who are dealign with these issues receive the best possible care.

11 thoughts on “The obstacles presented by ideology in discussing trans issues

  1. Absolutely excellent article. As a psychotherapist, I’ve really seen how ideology hamstrings the very thing we are trying to do in therapy – helping people to think critically about their lives.
    Really, I am so amazed to read this. This isn’t rocket science, but when fogged in with ideology even basic logic feels out of reach – because, it in fact is out of reach. Ideology mimics thought, but it is a freeze frame, a static portrait of reality, it literally smothers true reality. It can feel impossible working within this frozen, false world that is so easily shattered. Those who get pulled into it must submit and commit to managing chronic cognitive dissonance. But after awhile, people can’t tolerate so much upheaval, they finally just let their own intuition die. It’s easier than managing the conflict between what is stated and what is observed.

    Liked by 1 person

  2. What you call “identitarianism” is now the law of the land in the United States, and the principal reason for the gender (and sex) neutral definition of marriage.

    According to the famous SCOTUS decision in Obergefell, fundamental Constitutional rights “extend to certain personal choices central to individual dignity and autonomy, including intimate choices that define personal identity and beliefs”.

    Are you saying you are disagreeing with the Court? You sure have a right to – in fact the late Justice Scalia criticized this particular passage scathingly.


    1. This is actually an example of the very kind of thinking I am concerned about. You are making an argument based on who I agree with or disagree with in my opinion. Whether I agree or disagree with Scalia or the Supreme Court or liberals or conservatives or anyone else it not relevant to the truth of my opinion. Psychology, if it is to be a science, needs to be considered with truth independent of ideology, and the degree to which ideology takes hold it is no longer concerned with truth. This wouldn’t matter if it was liberal ideology, social justice ideology, conservative ideology, religious ideology or anything else, the result would be the same.


      1. This is true regarding purely scientific research. However, therapy lies at the intersection of science and practice. And when we are talking about practice, especially licensed practice, the law of the land can not be ignored.

        “Affirming identity” is no longer just an ideological matter. It is a legal matter. I am not a lawyer, this is not legal advice, but I suspect this can play out very much in the therapy space.

        It is also important that identity is described in terms of “choice” – and these terms are in no way limited to progressives. Fundamentally they are classical liberal, not progressive. I strongly suspect, in fact, that if any moves are made to ban “ex-gay therapy” (or “ex-trans therapy”) for adults as opposed to children, this very decision will be cited in a legal challenge – because an adult can choose not to follow their sexual inclination and that, too, is an “intimate choice defining identity”.

        As for scientific research, the problem of ideological diversity can be rectified to a significant extent by international collaboration. You can work with Russians, for example. Russia has a large medical scientific community and a very different dominant ideology.


  3. Unfortunately working with international scientists isn’t an option.

    Gender politics and identitarianism in the US has growns to such ridiculous extremes, that parts of the population consider it hatespeech and blatant bigotism, if you question whether a woman can have a penis. Think of all the transwomen!

    Needless to say, scientists from Europe or Russia presented with this kind of logic (Of course a woman can have a penis! She identifies as a woman, you hatemonger!) would merely look at you with a mix of confusion and disgust, take out their phone and ask for a taxi to the airport.


    1. Oh no, you do underestimate the Russians. Many of them will gladly engage in what they believe is a mission to save the West (some will say “white West” even) from the grip of ungodly “tolerasty”.


      1. Ah yes, the white west… Unfortunately for international cooperation, Russia and for that matter much of Eastern Europe had a dramatically different millennium than most of Western Europe. The west went on crusades, while the east had several centuries of Muslim/Pagan incursions in the form of Tatars, followed by almost half a millennium of a cold, and occasionally hot war, with a Muslim superpower.

        I suppose that does something to change your perspective…


  4. And speaking of the east, Thirdwaytrans should write something on the topic of Iran, which as you might have heard, is one of the world leaders in the number of SRS surgeries performed every year.

    I’ve occasionally heard it presented, rather disingenuously, that this is somehow proof of how tolerant the Islamic state of Iran is, when in fact it’s the opposite. Homosexual sex is still forbidden in Iran, and since it is an Islamic republic, it can neither be allowed nor ignored.

    SRS comes in handy as a medical solution to a medical problem. You’re not gay you see… Merely have a female brain in a male body, but we can fix that!

    It’s probably only a matter of time before conservative Christians pick up on that model in the US. And will undoubtedly be praised and celebrated in the media for how modern and tolerant they are.


    1. The classical Christian understanding is that body and mind are inextricably linked, that matter is actually a good thing, and that body is the temple of the Holy Spirit and thus deserves respect. Messing about with the body in ways that are risky/harmful is not something that mainstream Christianity would necessarily endorse, regardless of conservative Christians’ views of homosexuality. (Gnosticism, on the other hand, views spirit as divine and body as earthly/evil. That’s a philosophy entailing a much bigger mind/body split than Christianity.)


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