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I am grateful for the opportunity to respond to this letter from the chairs of the American Psychoanalytic Association’s Committee on Gender and Sexuality (COGS). I welcome substantive critiques of my work to refine my thinking, raise unconsidered questions, and further discussions about gender dysphoria and gender diversity. I was disappointed to find that the letter does not engage with the content of the paper.
Notably, the authors ignore the psychoanalytic perspective I articulate in my paper, instead mounting an attack on the Society for Evidence Based Gender Medicine (SEGM), of which I am the president. Therefore, I must first address their claims about SEGM, which they use in an attempt to discredit my work. Throughout my time writing about gender dysphoria, I have become accustomed to these attacks, which have become repetitive and expected. They are the price paid by anyone who questions the gender-affirming approach, particularly in the USA.
The authors’ claims are derived from a highly subjective and misleading report published by the Southern Poverty Law Centre (SPLC). SEGM has published an extensive response to the charge that we are a “hate group” (Society for Evidence Based Gender Medicine 2025), demonstrating that this designation is unfounded and that the allegations on which it is based are false. I encourage readers to familiarise themselves with our response. Using a political hit piece, such as the inaccurate SPLC report, to discredit certain voices illustrates the ongoing rejection of science that I describe in “Trans is not the new gay”.
While the authors frame SEGM’s, and my, concerns as being wildly out of step with mainstream medicine, it is the USA that is looking increasingly out of step with the rest of the world. One of SEGM’s main functions is to critically evaluate the outcome studies and highlight their methodological shortcomings. Our concerns have been validated by numerous research groups via peer-reviewed systematic reviews, conside