A Transgender Pediatrician & The Sovereign Self

A time is coming when men will go mad, and when they see someone who is not mad, they will attack him, saying, “You are mad; you are not like us.”

St. Anthony the Great

A civilization in a death spiral can no longer maintain the moral demands that kept it alive. Neither can it tolerate an ability to see things as they are. Coherent authority shrinks. In The Triumph of the Therapeutic, Philip Rieff put it well: The dying order “demands less, permits more.” No longer able to distinguish between spectacle and reality, it substitutes one for the other.

Of all contemporary spectacles, none is a clearer “sign of the times” than the transgender delusion. By embracing and promoting it, the mental health profession abandoned troubled patients to their symptoms. Instead of guiding patients past their distortions, clinicians now affirm them.


Figures over the entrance to Bedlam
Figures of Melancholia and Mania over the entrance to Bedlam.


Consider Dr. Rachel Levine. A transgender pediatrician and professor of pediatrics and psychiatry at Penn State College of Medicine, he was Pennsylvania’s state health director from 2015 to 2017. He has been appointed assistant secretary of Health and Human Services in the Biden regime. Rachel is the synthetic replacement for the preceding Dr. Levine, dead name Richard.

The first Dr. Levine (b. 1957) was a married man with a son and daughter. In his 40s, Richard decided to go on a gender journey. Still married, he set out to deny the evidence of his genetic endowment: the inevitable Y chromosome in each of his 30-40 trillion cells, including some 100 billion neurons plus multiple times more glial cells.

Were Rachel Levine a private person, an obscure man suffering anonymously the anguish of self-loathing, he would elicit compassion and concern. Courtesy might move any one of us to assent to the counterfeit, and address him as the woman he strains to be. But Levine is not a nameless sufferer seeking relief from personal distress and wanting only to get on with his life. He is a public figure, the highest ranking transgender official in the United States, and one with the capacity to affect the well-being of others. Children especially.


Book cover for "Inventing Transgender Children"
Book jacket for a text by Cambridge Scholars Publishing (2019).


Levine advocates puberty blockers, thereby grooming even the youngest to deny the reality of their bodies. He supports life-altering surgeries although the great majority of youngsters outgrow their “dysphoria” after puberty. Sympathy stops at the gate of the toxic narcissism of an influential man empowered to inflict irreversible harm on other people’s children. In effect, unsettled children serve as tools for normalizing what common sense recognizes as his own pathology.

Only we dare not say so. Under the new McCarthyism, any suggestion, however nuanced, that transgenderism is an ideology rooted in mental illness, is subject to reprisal. Standards of truth and morals by which behaviors are judged in a civil society have been reduced to the feelings of a sovereign self.

Increasing medicalization of the variety of emotional responses of sensitive people to the boundless stresses of the lived life, is reflected in the ever-enlarging Diagnostic and Statistical Manual of Mental Disorders (DSM). It grew from 119 pages in 1969 to 886 pages in the fourth edition (DSM-IV). DSM-V is larger still.


Transgender "man" and "his" husband
Rick Zentler (right), a transman and “his” husband. Zentler froze “his” eggs prior to hormone replacement to enable “him” to have a biological child.


Science began leaching out of clinical practice when the word gender was plucked from the rules of grammar and applied to persons. The DSM, published by the American Psychiatric Association, is a moveable feast of culturally flexible diagnoses, some real, some the brainchild of their backers. The term gender identity, absent from the first two editions in 1952 and 1968, slid into the lexicon in the 1970s. Gender identity disorder first appeared in the fourth edition in 1994. In 2013 it was removed from DSM-V, replaced by gender dysphoria. Also added, for the first time, was a section on “gender dysphoria in children.”

Gender reassignment is the currently approved term because, in truth, sex change is impossible. There is no erasing that Y chromosome. It will not dissolve or somersault into a second X chromosome. Neither can we switch our natal gametes. There are only two: the female ovum or male sperm cell. There is no choice in the matter. By contrast, there is no cap on the number of genders clamoring to be discovered. (New York City’s official tally is 31 so far.)

Follow the science? Only until science interferes with pronouns and ideological dogma. Then the experts in gender theory—the new gnosis—parachute in to enforce compliance with a psychiatric condition that refutes the facts of existence.

Whatever the outcome of sex surgery chosen by any individual, every transgender man or woman is an artifact. Medical cunning can only disguise, not abolish, what biology determined in the womb. [Transgenderism is not intersexuality, a rare birth defect involving urological abnormalities and genital ambiguity.] The illusion is successful to varying degrees with different people. With some, the artifice is pronounced. Dr. Levine is a conspicuous standard bearer for a species of radical individualism indistinguishable from psychosis.

In a less sentimental era, those who defined their “own concept of existence, of meaning, of the universe” might be confined to an attic, like Mr. Rochester’s wife in Jane Eyre. Others were committed. In London, that often meant detention in the asylum that came to be called Bedlam. The Mayor of London, circa 1450, declared Bedlam a “place [where may] be found many men that befallen out of their wits.” In our tender day, a particular class of befallens is celebrated as an icon of conscientious liberty and the courage to be oneself. No matter if the uncovered self is as artificial as a Venetian canal in a Las Vegas resort.


Fake canal at a Las Vegas resort
Gondolas on the fake canal at The Venetian, Las Vegas.


Aggressive promotion of transgenderism from a position of public trust warrants repudiation. Levine claims attention for a fabricated identity and wields power on the basis of it. For that reason he forfeits the suspension of disbelief offered out of simple kindness to trans men and women who suffer quietly the clay of which we are made.

Mania for transgenderism prompts troubled people—many in their teens—to self-diagnose. Egged on by social media, pop culture, and YouTube, they misjudge the origin of their unease. Affirmed by experts in gender management, they change their bodies instead of their perceptions. Mutilated, they are left to make a life out of a misdiagnose.

Dr. Paul McHugh, chief psychiatrist at Johns Hopkins in the 1970s, shut down its gender identity clinic in 1979. He explained in 2004: “I concluded that to provide a surgical alteration to the body of these unfortunate people was to collaborate with a mental disorder rather than to treat it. ” His essay “Surgical Sex” should be read in its entirety. Here, a central point:

Men (and until recently they were all men) with whom I spoke before their surgery would tell me that their bodies and sexual identities were at variance. Those I met after surgery would tell me that the surgery and hormone treatments that had made them “women” had also made them happy and contented. None of these encounters were persuasive, however. The post-surgical subjects struck me as caricatures of women. They wore high heels, copious makeup, and flamboyant clothing. . . . but their large hands, prominent Adam’s apples, and thick facial features were incongruous (and would become more so as they aged)

Female psychiatrists whom I sent to talk with them would intuitively see through the disguise and the exaggerated postures. “Gals know gals,” one said to me, “and that’s a guy.”


Rachel Levine
Dr. Rachel Levine


The transgender craze is contagious. Anyone who might spread a physical infection must quarantine. Yet the carrier of a social and psychological virus is promoted to a platform that masks the virulence and promotes the malady. It is time to say goodnight to those mental health professionals whose investment in the twin gospels of self-fulfillment and transgenderism upends rationality.

Missing from discussions of transgender is reference to religious upbringing. How many trans people were raised hearing the luminous words of God to Isaiah: “Before I formed you in the womb, I knew you.” How many learned at the parental knee that they were made in the image and likeness of God? And so, despite its flaws and limitations, their bodies enjoy an immense dignity? Carl Jung, looking back on his thirty years as a psychotherapist, wrote:

Among all my [adult] patients . . . there has not been one whose problem in the last resort was not that of finding a religious outlook on life. It is safe to say that every one of them fell ill because he had lost that which the living religions of every age have given to their followers, and none of them has been really healed who did not regain his religious outlook.

The imperial self is a dominant player in many decisions to “transition.” Nyla Rose, a transgender wrestler in the women’s division of All Elite Wrestling, explained his decision to transition. He was in his twenties: “I [had] to do this for me. . . . For my own health and well being, I had to be myself.”


Nyla Rose, transgender wrestler
Nyla Rose. 2019.


How modern, this quest to be oneself. Transgender begins with the precarious assumption that the discovered self will be an improvement on the existing one. It is a poignant expectation. Henri de Lubac, writing in the decade (1950s) George William Jorgensen went to Denmark to became Christine, said this:

Noverim me, noverim te. May I know myself, and may I know you, O God, my God!  .  .  . I cannot get to know myself without seeking to know God—for in my very being I am relative to God. The subtlest investigations and the most learned reflections only serve to lead me astray instead of revealing me to myself so long as I try to know myself alone. Man only knows himself—can only desire and love himself in God or before God. Noverim me, noverim te.

The man of prayer discovers in himself and upon himself the light which the man in search of his “self” does not discover.

The pieties of our secular moment, careless of moral reasoning, have no patience for prayer. Pharmacological or surgical intervention is a quicker fix for the sorrows of living.

Note: An edited version of this appeared first on The Federalist, March 29, 2021.

Correction: Dr. Levine’s birth name was Richard, not David as originally stated. Text has been corrected.