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The madness of ‘gender-affirmative’ medicine
Australian psychologist Dianna Kenny is a leading critic of the transgender movement. Mercator interviewed her about her latest book, Gender ideology, social contagion, and the making of a transgender generation.
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You state that "social contagion" is a key factor in the rise of gender dysphoria cases among adolescents. However, Rapid-Onset Gender Dysphoria (ROGD) is often described as a "controversial and scientifically unsupported hypothesis." Is this the case?
It is a common error to conflate ROGD with social contagion. The construct of social contagion existed long before ROGD and is independent of it. ROGD is simply one manifestation of social contagion at work in the current context of gender identity and gender medicine. Social contagion describes the spread of psychological phenomena such as attitudes, beliefs, and behaviours across network ties. Network ties are the social bonds between individuals and groups in which mutual influence occurs between members of those social networks.
There are many historical examples of the utilization of networks of social influence to achieve subscription to new political or social ideologies. Cults represent an extreme form of social contagion. Threats of sanctions including fear of job losses and public humiliation of dissenters serve to silence opposing views or even inquiries, thus cementing the new ideology to the exclusion of dissenting views. We observe this frequently in the way in which trans activist zealots expunge opposition.
Social networks include families, schools, sports teams, and residential care facilities. There are many examples that predate the internet, social media, and the gender identity debate. It has been documented through the ages – for example, the witch hunts during the Inquisition in the Middle Ages, the suicide clusters that occurred after Goethe wrote a book about a young man who died by suicide in the 19th century, and more recently the "recovered memories" contagion, and repetitive strain injuries (RSI) in the workplace in the 1980s.
ROGD has a lot of empirical support; trans ideologists deny its existence because it would result in the collapse of one of gender ideology's foundational beliefs – that children "just know" whether they have been born in the wrong body. Social contagion suggests that such a belief has been created by the social context in which the child lives, not by some innate "knowing" completely independent of their environment.
How do social media, peer influence, and other cultural pressures contribute to this "rapid" form of gender dysphoria? In your view, why are adolescent females more frequently affected by ROGD compared to males? Are there specific psychological or social factors that make this population particularly vulnerable?
There are three main mechanisms that I propose to be involved in the social contagion of gender dysphoria and the development of ROGD. These are peer contagion, deviancy training, and co-rumination.
Peer contagion is a form of social contagion, defined as a process of reciprocal influence to engage in behaviours occurring in a peer dyad. Peer contagion has a powerful socializing effect on children beginning in the preschool years. By early childhood, the time spent interacting with same-age playmates frequently exceeds time spent with parents. By middle childhood, gender is the most important factor in the formation of peer associations, highlighting the significance of gender as the organizing principle of the norms and values associated with gender identity.
Deviancy training, in which deviant attitudes and behaviours are rewarded by the peer group, has a significant effect on the development of antisocial attitudes and behaviours such as bullying, physical violence, weapon carrying, delinquency, juvenile offending, and substance abuse.
Another form of peer contagion in adolescence is co-rumination, a process of repetitive discussion, rehearsal, and speculation about a problematic issue within the peer dyad or peer group that underlies peer influence on the development of depression, anxiety, self-harm, suicidal ideation, and suicide.
Young people are particularly vulnerable to peer contagion if they have experienced peer rejection, hostility, and/or social isolation from the peer group. Protective factors against peer contagion effects include secure attachments to parents, adequate adult supervision, and oversight of the young person’s activities, school attendance, and the capacity for self-regulation.
Of course, social media has a major role to play in the upsurge of gender dysphoria in young people in the current era. A number of ingenious studies have demonstrated the complex mechanisms at play in social media's role of spreading beliefs and behaviours, including serious psychological disorders like self-harm, suicide, and eating disorders among users.

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Like many other professionals, you are critical of "gender ideology" and the "affirmative care" approach to managing gender dysphoria. What do you see as the main limitations of this approach? What irreversible consequences or harms might result from it?
Fundamentally, the entire edifice of gender medicine is built upon the sand of gender ideology, a crazy, illogical, nonsensical conglomeration of ideas about how one develops a gender identity and how some come to realize that they have been "born in the wrong body."
Disturbingly, young people are convinced by those who should be safeguarding their welfare that there is a remedy for their gender incongruence or gender dysphoria that has euphemistically been titled "gender affirming care." It is built on four steps – social transition, puberty blockade, cross sex hormones, and genital and other surgeries – to create the desired body.
Firstly, it is simply not possible to "change" sex. The best outcome achievable is a masculinized female or a feminized male. The costs are high - lifelong patienthood, increased incidence of diseases like cancer and heart disease, loss of sexual function, loss of fertility, loss of bone density if treatment is started young, loss of IQ over time, more rapid ageing in men on estrogen, vaginal atrophy in women on testosterone.
The list of complications is endless, to say nothing of the social consequences of transition that include homelessness, unemployment, under-education, vilification, marginalization and so on. Research has shown that young people with gender dysphoria in late childhood/early adolescence will resolve this spontaneously by early adulthood if not derailed with exogenous hormones. Many such young people will eventually accept that they are gay.
The obscene haste with which the gender doctors are perpetrating acts of malpractice on their young patients is reprehensible because they can have no idea which of these young people will benefit from their interventions. The existing data suggests only a small minority – leading to the conclusion that many more will be harmed than helped.
Do you believe that the medical system and healthcare professionals are operating under ideological or social pressure?
Absolutely! This is a major issue that has not been acknowledged or discussed openly.
There have been a great number of professionals with dissenting views who have been seriously harmed by their institutions for not sycophantically following the party line. This includes those who have suffered job loss, public humiliation, and threats of violence and death.
It is disappointing to see appointed leaders of organizations such as hospitals, schools, sport, politicians, and the courts remain silent and acquiesce to the strident voices of gender ideology when in private they acknowledge that gender ideology is a case of "the king has no clothes”. Too many lack the moral courage and integrity to resist the regressive forces of the trans lobby.
You advocate for a psychotherapeutic approach to addressing gender dysphoria in young people and their families. What does this approach involve? How does it differ from the medicalized approach? Have there been positive outcomes?
A psychotherapeutic approach should be the first line of treatment. We know that young people presenting with gender dysphoria have complex mental health needs. Many of them are neurodivergent and suffer from conditions like ADHD, depression, anxiety and OCD. These remain untreated in the gender affirming care model.
The young people naively believe that all their problems will resolve once they are confirmed in their "right" body. Of course, we know this to be utterly false – that for a great many, their problems are compounded, not diminished. What is involved in psychotherapy is very complex and you will have to read my book where I cover this in great detail.
You call for a governmental response and a public health campaign. What measures do you consider necessary to stop what you describe as the "medical madness" of gender-affirming care?
Australia needs to do what other sensible countries are doing:
- Stop the practices through legal and legislative means.
- Prohibit the prescription of puberty blockade and cross sex hormones.
- Criminalise gender surgeries.
- Withdraw medical insurance coverage from doctors who continue to prescribe and surgeons who continue to operate and threaten their accreditation and right to practice.
- Restore parental authority to parents.
- Forbid schools from socially transitioning children without parental knowledge or consent.
- Reverse self-ID legislation.
A million things need to happen at once. This scourge needs a top-down (government) and bottom up (parents, teachers, health practitioners) approach plus a widespread public health campaign, plus therapy for young people continuing to struggle with their mental health via proclamations of gender dysphoria.
Is banning gender-affirmative medicine too radical?
Formerly Professor of Psychology at The University of Sydney, Australia, Dianna Kenny is now in full time private practice specializing in child and adolescent mental health, early trauma, child sexual abuse, and gender dysphoria. She is a scholar of international standing, author of 12 books and over 300 scholarly publications, and a frequent keynote and invited speaker at national and international conferences.
Image credit: Bigstock
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mrscracker commented 2025-01-28 11:44:58 +1100Well Mr Mouse I guess there are privacy issues and safety issues and those can each look a little different.
I believe we all want what’s best for each other but we can operate under different understandings. And from different perspectives.
You have a blessed night. 🙂 -
Anon Emouse commented 2025-01-28 08:08:59 +1100So what about gay males in women’s restroom mrscracker? Surely they present no threat to the women in there. Is that the line we’ll draw? Do we need genitalia inspections before people go into a restroom?
Personally, I think we make far too much of bathroom discussions. I think the author of this article is deliberately ignoring difficult questions because it undermines her belief system. -
mrscracker commented 2025-01-27 00:52:03 +1100Good morning Mr. Mouse. I hope this finds you well.
I think it illustrates where we are as a society when well intentioned people discuss which restroom facilities celebrities will use following their castration and cosmetic procedures.
Back in the day eunuchs were high status and permitted in the harems because they posed no threat to the female occupants. I suppose if a male has undergone a similar mutilation and presents as a woman no one in the Ladies Room would even notice should they use the facility.
In other situations perhaps a single occupant bathroom would be a solution.
Who would have thought that today we’d be imagining dillemas more appropriate to the Ottoman Empire?
I hope you have a blessed day Mr. Mouse and thank you for your comments.
🙂 -
Anon Emouse commented 2025-01-26 12:20:16 +1100mrscracker,
Which bathroom would you ask Caitlyn Jenner to use? -
mrscracker commented 2025-01-26 07:51:28 +1100Thank you so much for this article.
I was looking at information recently about the social hysteria of a century ago: eugenics and the estimate of 60,000 to 70,000 victims in the USA, some being minors.
I think every era has its own social hysteria and contagion be it eugenics, witch hunting, or transgenderism. Once the tide begins to turn most people drop away from their advocacy.
Otherwise good and decent people get taken in by these ideologies. Eugenics was once considered a progressive way to reduce disease, poverty, and generational suffering. Teddy Roosevelt and even Helen Keller were eugenic advocates.
I believe the tide has begun to turn for the transgender ideology and hopefully we can move forward from this century’s errors just as we did in the 1900s. -
Anon Emouse commented 2025-01-26 01:11:22 +1100Janet,
Chloe Cole seems like the vocal minority here. She started de transitioning after taking LSD and hallucinating.
Out of curiosity Janet how many gender affirming surgeries have been performed on minors over the past four years? Fewer than 1000 -
Paul Bunyan commented 2025-01-25 20:10:17 +1100People regret knee surgery as well. Chemotherapy is also prone to regret since it causes nausea, weight loss, malaise etc in 100% of cases. Informed consent is paramount.
Fewer than 1% of people who transition regret it.
https://www.sciencedirect.com/science/article/abs/pii/S0002961024002381
Many people also regret adopting children or having biological children, and those acts are far more consequential.
https://time.com/6966914/parental-regret-children-ro-kwon-essay/ -
Janet Grevillea commented 2025-01-25 20:05:47 +1100“Medicine is all about improving quality of life and making people happier. It’s also about alleviating suffering, including psychological and emotional suffering” which makes it so disturbing and disgusting that so many young people have been harmed by so-called “care” under the gender-affirming banner. Many of us have heard detransitioner Chloe Cole speak of her experience of suffering and she is just one of many.
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Paul Bunyan commented 2025-01-25 17:18:50 +1100Medicine is all about improving quality of life and making people happier. It’s also about alleviating suffering, including psychological and emotional suffering.
Elon Musk didn’t need treatment to fix his baldness. Why don’t the anti-woke crowd rail against things like that? -
Janet Grevillea commented 2025-01-25 10:28:15 +1100This argument that “gender affirming care” affects such a small percentage of the population that we should not worry ourselves about it, is false. Gender affirming care sits within gender ideology which, in Australia, has captured governments, public service departments, the legal profession and law courts, educational institutions including those that train teachers, and sporting bodies.
The gender movement affects me and all other women in Australia. We are no longer allowed single-sex facilities. We have to admit men who identify as women to refuges, change rooms, toilets, support groups and, in come sports, to women’s sporting teams.
This is because, in 2013, the law was changed by the Julia Gillard government to make it illegal to discriminate against people on the basis of their gender identity. In a recent court case lesbians were told we are not allowed to hold public gatherings unless we include men, i.e. men who identify as women who are attracted to women (whom we see as heterosexual men). The outcome is that lesbians can only continue to exist in isolation or underground.
The gender movement has nasty violent members. On social media sites there are horrible threats, including death threats, against female lesbians who decline to have sex with men who identify as women who are attracted to women. They call themselves ’transbians’; we see them as heterosexual men, probably affected by autogynephilia. If you don’t know what it means, look it up.
The policy of gender-affirming care is not a minor issue affecting a small group of people. Psychiatrists and other health professionals have lost their jobs because they refused to enact it. Jillian Spencer, a psychiatrist who believes that sex is immutable, said she would stand as President of the Royal Australian and New Zealand College of Psychiatrists. A group of transactivists tried to prevent her standing. Fortunately they failed. Many of us are hoping she will be elected. So, gender-affirming care affects children, adolescents and adults who are unhappy in their biological sex. It also affects all of us. Lots of men have not yet realised that, because they are not as badly affected as girls and women. -
Janet Grevillea commented 2025-01-24 11:44:50 +1100Thank you for this article Dianna Kenny. From being a country strongly opposed to female genital mutilation we now have a medical/legal/social system that encourages male and female genital mutilation. Do we call that progress?
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Anon Emouse commented 2025-01-24 01:11:16 +1100Ok, Dianna -
You are aware there are plenty of non-trans reasons to prescribe puberty blockers to children, right? Should we ban those, too?
Also, I’m confused. You seek to “restore parental authority” to parents. What if parents, in consultation with medical professional, determine that the best course of action is to have gender affirming surgery? Should parents, using their “parental authority” be allowed to do that? -
Dianna Kenny commented 2025-01-24 00:26:16 +1100disappointed to read comments from the ill informed. The impact actually affects all facets of society and is therefore worthy of public debate.
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Emberson Fedders commented 2025-01-23 23:16:03 +1100Yes, surely there are more serious issues that affect far more people that you could be fighting instead.
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Anon Emouse commented 2025-01-23 23:01:05 +1100I’ve never seen someone get worked up about such a small percentage of the population, Dianna.
Are you also against breast implants? Those are a form of gender affirming surgery, too. -