Frequently Asked Questions

Gender identity activism is based on a belief that everyone has an innate sense of being masculine, feminine, or neither, and that this feeling does not always correlate with their sexed bodies. They believe that a person’s gender identity should take precedence over their observable sex and that everyone else must accept their self-identification. There is a range of views within gender identity activism, with some acknowledging that sex is an objective classification and others contending that sex is on a spectrum and that binary classifications are scientifically false. The more extreme activists say that there are hundreds or thousands of distinct and legitimate gender identities, all of which should be recognised by others. Extreme trans activists demand that the subjective concept of gender identity should replace the objective reality of sex in all government policy and law. For example, NZ law now allows anyone (including children) to have their birth certificate changed (multiple times) to the sex they self-declare. The fact that the birth certificate has been changed is permanently hidden from public view.

The Ministry of Education published the updated Relationship and Sexuality Education Guidelines (RSE) in September 2020 which is heavily supportive of gender identity thinking. Our critique of the Guidelines is here. The Guidelines are based on Gender Identity Theory that argues that everyone has an inner feeling of masculinity, femininity, or neither that is known only to themselves and should be automatically affirmed by others, including at school. The alternative explanation for gender distress, the Developmental Model Theory, is not mentioned at all. This theory recognises that there is a very long history of people developing behaviours to manage distress and becoming fixated on them - such as obsessive compulsive disorder, anorexia, cutting and now gender dysphoria. Given the right support, there is also a very long history of people recovering from these conditions, however the MOE Guidelines do not suggest this alternative approach to schools. Schools are required to consult their community on the contents of sexuality education and parents retain the right to withdraw their children from these lessons. However, parents are often unaware of the incidental discussion of trans beliefs in everyday classroom conversations. Advice on how to communicate with your school on this issue is here. In the name of being inclusive and kind, schools and other students feel they must use new names and pronouns (see below) for transgender children and must provide special facilities for them. The RSE guidelines direct schools to allow students to use the facilities “of the gender identity they are most comfortable with” and students are often not consulted or are pressured into agreeing with that policy. The RSE guide encourages schools to support a child’s social transition (see below) without mentioning the need to consult parents. Under the Education Act, principals are expected to inform parents of any matters that in the principal’s opinion “are preventing or slowing the student’s progress... (or) harming the student’s relationships with teachers or other students.” This expectation is entirely dependent on the principal’s opinion and there is no case law to clarify the extent or limits of the principal’s decision. If the principal is fully supportive of organisations like InsideOUT and follows its advice, parents will not be informed. Some parents of trans children are not informing the school of their child’s transition and the Human Rights Commission recommends that, if known, schools keep the transition a secret from other parents. This removes the right of other parents to know who their child shares space with in school changing rooms and on school camps. Rainbow organisations with good funding have been able to influence LGBTQ education in schools in many Western countries, including NZ. Under the guise of anti-bullying programmes, many schools contract out to activist groups to provide sex education that confuses children about biological reality and can persuade them to claim a gender identity. Support groups for lesbians and gays in schools are disappearing in favour of transgender support. It has become ‘uncool’ to be lesbian and the attention and compassion for the rainbow community is now mostly reserved for those with a trans identity. In the past, children who were gay or lesbian were often bullied. Now it is becoming common for children to be bullied for not being ‘queer’. Some children have discovered that adopting a non-binary persona is a necessary safeguard.

Contrary to trans activists’ claims, requiring people to use ‘preferred pronouns’ is not inclusive, nor is it kind. It forces everyone to take sides in an ideological belief and can lead to bullying of those who choose the ‘wrong’ pronouns for themselves, or accidentally use the ‘wrong’ pronoun for others. Using preferred pronouns has become a linguistic game that “cultivates fragility, entitlement ... and brainwashes children into hating their bodies.” Pronouns have become weaponised, leading to accusations of ‘misgendering’ that are used to excessively punish small perceived errors in speech with charges of bigotry and violence. ‘Preferred pronouns’ are touted as a mark of respect but they are more often a mark of submission. Many people object to being compelled to use chosen pronouns, for example in cases where female victims of violence have been required to address their male abusers as ‘she’. Trans activists, representing about 1% of the population, are demanding radical changes to the language for the other 99%. ‘Women’ has been given a circular and nonsensical new meaning: a woman is now any person who feels like a woman. Medical terms for women’s anatomy and bodily functions are being discarded in favour of words that are disconnected from women altogether: vagina becomes ‘front hole’; breast-feeding becomes ‘chest feeding’; mother becomes ‘birthing parent’. Pride in being a girl, woman or a mother is taken away. These new terms, designed for the comfort of a very few, will result in disadvantaged women and girls being even further distanced from the health care they need.

Social transition can mean anything from choosing a gender-neutral nickname and wearing androgynous clothing, right through to adopting an opposite sex name, pronouns, and clothes and wanting to be recognised as the opposite sex by everyone else in all facets of life. Far from being “kind and affirming” as claimed, it fixes the new identity and makes it harder for children to later change their minds. When everyone else is expected to go along with the fiction, children are learning that affirming another’s belief is what matters and questioning is wrong.

Dr Lisa Littman, Public Health Assistant Professor at Brown University, coined the term Rapid Onset Gender Dysphoria (ROGD) after studying the phenomenon of the sudden onset of gender dysphoria amongst girls belonging to a peer group where multiple friends have become transgender-identified during the same timeframe, often accompanied by lengthy periods spent on social media and the internet. Some of the results from Littman’s study are: 41% of the participants had expressed a non-heterosexual sexual orientation before identifying as transgender; 62.5% had been diagnosed with at least one mental health disorder or neurodevelopmental disability prior to the onset of gender dysphoria; in 36.8% of the friendship groups, the majority of the friends became trans-identified; and 49.4% tried to isolate from their families. Boys and young men also experience ROGD. Some of their stories have been collected in a four part Quillette series. There has been a twenty fold rise in the number of people seeking transition, with teenagers hugely-overrepresented. Between 2007 and 2017, the number of transgender youth clinics in the US went from 1 to 41 and the number continues to increase. A survey in the UK has found a 15 fold increase in children being referred for gender treatment since 2010, and also a marked regional difference with referrals in Blackpool three times the national rate. In this 5 minute video, Abigail Shrier explains the phenomenon of Rapid Onset Gender Dysphoria (ROGD) and its tragic effects on a generation of (mostly) girls. Shrier is the author of Irreversible Damage: the transgender craze seducing our daughters.

Puberty blockers are an experimental treatment that is too readily prescribed to young people who cannot fully understand the consequences. Puberty blockers are drugs that were developed for the treatment of prostate cancer and they have never been certified as safe and effective for treating gender dysphoria. Multiple reviews of the use of puberty blockers have all found a lack of evidence for their safety or efficacy. These reviews include: Finland 2020 revised its treatment guidelines, prioritising psychological interventions and support over medical interventions. Sweden 2021 The Karolinska Hospital ceased the use of puberty blockers for those aged under 18. Sweden 2022 Following a comprehensive review, the Swedish National Board of Health and Welfare concluded that the evidence base for hormonal interventions for gender dysphoric youth is of low quality and that hormonal treatments may carry risks. As a result of this determination, the eligibility for pediatric gender transition with puberty blockers and cross-sex hormones in Sweden will be sharply curtailed. France 2022 The French National Academie of Medicine recommended caution in the use of puberty blockers: “...the greatest reserve is required in their use, given the side effects such as impact on growth, bone fragility, risk of sterility, emotional and intellectual consequences and, for girls, symptoms reminiscent of menopause”. Florida 2022 The Florida Department of Health issued new guidelines on treating gender dysphoria for children and adolescents which recommends that minors should not be prescribed puberty blockers or hormone therapy. United Kingdom 2022 An independent review, led by Dr Hilary Cass, highlighted a profound lack of evidence and medical consensus about the best approach to treating gender dysphoria in children. Norway 2023 After a review, the Norwegian Healthcare Investigation Board stated it has serious concerns about the treatment of gender dysphoria in children and that the current ‘gender affirming’ guidelines are not evidence-based and must be revised. Denmark 2023 In a marked shift in the country's approach to caring for youth with gender dysphoria, most youth who are referred to the centralised gender clinic now receive therapeutic counselling and support, rather than a prescription for puberty blockers. New Zealand 2022 In September 2022, the NZ Ministry of Health website quietly removed its description of puberty blockers as being “safe and fully reversible” and replaced it with “Blockers are sometimes used from early puberty through to later adolescence to allow time to fully explore gender health options.” Unlawful. In this article, Bernard Lane describes how the NZ Ministry of Health was warned by Medsafe in September 2022 it could be breaking the law by publicising the off-label use of puberty blockers for children. Questions mount around the use of puberty blockers in children. by Jan Rivers. "New Zealand rates of puberty blocker use are much higher than the UK, where the Tavistock Clinic’s Gender Service (GIDS) was closed due to unsafe practices. In New Zealand, Dr Sue Bagshaw reports that 65 per cent of her clinic’s 100 patients receive them. The Tavistock GIDS clinic prescribed blockers to about 6 per cent." Flaws in Dutch Puberty Blocker Study 2023 A peer-reviewed open access publication has exposed deep flaws in the Dutch studies that formed the foundation for youth gender transition and concluded that these studies should never have been used to launch the practice of youth gender transition into mainstream medicine. Puberty blockers are wrongly claimed to be fully reversible. Short term studies have shown changes to height, lower bone density, and potential interference with brain function, while long term effects are unknown. Treating gender dysphoria with puberty blockers is a medical experiment which may leave young people in a state of ‘developmental limbo’ without the beneficial effects of puberty on maturation and the development of secondary sex characteristics. A 2021 Swedish documentary described finding “case after case of irreversible treatment of young people gone wrong", including a 15 year old who has constant pain from severely reduced bone density after being on puberty blockers for four years. Nearly all young people who start puberty blockers go on to life-long use of cross sex hormones and their irreversible effects. In a study carried out by the Gender Identity Development Service in the UK, of 44 children who were referred for puberty blockers between the ages of 12 and 15, all except one – 98% of the cohort – progressed to cross-sex hormones. Studies have shown that a large majority (around 80%) of trans identified youth grow up to change their minds and accept their biological sex. The current rush to affirm a trans identity by some counsellors, clinicians and parents means large numbers of children are being medicalised when a ‘watchful waiting’ approach would have been most appropriate.

As with other Western nations, in the mid 2000s, Sweden enthusiastically started treating children who had gender dysphoria with hormones, followed by genital surgery. However, in late 2019, there was a sharp 65% decline in the number of referrals to gender clinics in Sweden, as shown in the graph below. This sharp decline corresponds with experts calling on the government to review treatment protocols and with the airing of a television documentary – Trans Train – that revealed to the population that medical transition of minors is not based on scientific evidence. In April 2021, Sweden announced a new policy for the treatment of gender dysphoric minors. Those under 18 will no longer be prescribed puberty blockers or cross sex hormones and doctors are required to give better explanations of the risks and uncertainties of transition. Following a comprehensive review, in February 2022 the Swedish National Board of Health and Welfare concluded that the evidence base for hormonal interventions for gender dysphoric youth is of low quality and that hormonal treatments may carry risks. As a result of this determination, the eligibility for pediatric gender transition with puberty blockers and cross-sex hormones in Sweden will be sharply curtailed. For most youth, psychiatric care and gender-exploratory psychotherapy will be offered instead. Exceptions will be made on a case-by-case basis, and the number of clinics providing paediatric gender transition will be reduced to a few highly specialised centralised care centres.

The exponential rise in teenage girls seeking medical gender transition began to raise alarm bells and the Keira Bell case confirmed that there are serious questions about the efficacy and long term impact of puberty blockers and cross-sex hormones. In April 2021 a report by the National Institute of Health and Care Excellence (NICE) found the evidence for using puberty blocking drugs to treat young people struggling with their gender identity is “very low”. A further independent review, led by Dr Hilary Cass, released an interim report in March 2022 that highlights a profound lack of evidence and medical consensus about the best approach to treating gender dysphoria in children. This is Dr Cass's latest update (Dec 2022) about the proposed changes to the UK's transgender medicine services. Following the interim Cass Report, in April 2022, the UK Health Secretary,Sajid Javid, announced an urgent review into gender treatment services for children in England, saying that services in this area were too affirmative and narrow, and “bordering on the ideological”. In December 2022 the Scottish parliament passed a bill allowing sex-self-ID. In January 2023, the UK Prime Minister, Rishi Sunak announced his government would block the legislation. Days later, Nicola Sturgeon, the then Scottish First Minister was embroiled in a controversy about a rapist who had self-identified into a women's prison. Time to Think by Hannah Barnes was published in January 2023. This Guardian review of the Gender Identity development service describes, "As referrals to Gids grew rapidly – in 2009, it had 97; by 2020, this figure was 2,500 – so did pressure on the service. Barnes found that the clinic – which employed an unusually high number of junior staff, to whom it offered no real training – no longer had much time for the psychological work (the talking therapies) of old. But something else was happening, too. Trans charities such as Mermaids were closely – too closely – involved with Gids. Such organisations vociferously encouraged the swift prescription of drugs. This now began to happen, on occasion, after only two consultations. Once a child was on blockers, they were rarely offered follow-up appointments. Gids did not keep in touch with its patients in the long term, or keep reliable data on outcomes."

For females, taking testosterone irreversibly deepens the voice, promotes the growth of facial and body hair, and enlarges the clitoris. It also can thicken the blood, increasing the risk of stroke or heart attack. Body fat is redistributed and sweat and body odour are affected. Vaginal atrophy (the thinning and drying of the vaginal wall) is usual and menstruation is reduced or ceases. Initially there is often a ‘high’ produced by the increased testosterone, with anxiety and emotional responses markedly reduced, but this may not last long term. For males, taking oestrogen causes the development of breasts, a reduction in muscle mass and body hair, reduced testicular size and sperm count, the redistribution of fat, a change in sweat and body odour and changes in emotions. For both sexes there is a loss of sexual function – vaginal atrophy in females (drier vaginal walls can cause pain during sex), and reduced erectile function in males. Both sexes can experience a change in sexual interest, arousal, and orgasm. There is also possible infertility in both sexes caused by the reduced ovulation and sperm production. Children who move directly from puberty blockers to artificial sex hormones will never go through the puberty for their sex and boys’ penises will remain permanently immature, at the size of a child’s. Gender-affirming surgery that includes hysterectomy and oophorectomy in transmen (females) or orchiectomy in transwomen (males) results in permanent sterility.

A lot of the hype around gender identity ideology says that sex re-assignment surgery is simple and that it will make the patient indistinguishable from someone born as the desired sex. The euphemisms used of ‘top surgery’ or ‘bottom surgery’ blatantly hide the truth. All sex-reassignment surgery is potentially dangerous, often disfiguring, and it never provides the full appearance and function of natural genitalia. Young people are being misled. Sex re-assignment surgery also permanently sterilises the patient through castration of males and the removal of the ovaries and uterus of females. Here are two accounts from people who have undergone the surgery, one from Scott Newgent and one from Melissa Vulgaris, describing what it was like for them. In this interview, detransitioner Ritchie Herron describes the catastrophic effects of his gender surgery which he says was "the biggest mistake of my life." On GB News, detransitioners Keira Bell and Ritchie Herron describe the lack of information they were given about the side effects of surgery and the pressure they felt under to agree to the recommendations of their doctors and therapists.

A detransitioner is a person who has undergone medical and/or surgical transition to the opposite gender but has later come to regret this choice and has reverted to their biological sex. Here is a personal account of detransitioning from Ellie and Nele and another from Sinead Watson. After ceasing the taking of cross sex hormones some of the changes wrought may be diminished but many of them, especially of course any surgeries, are irreversible. Reports that the percentage of people with regret is very low usually do not take into account the enormous and rapid increase in those identifying as transgender in the past ten years and websites to support detransitioners have attracted followers in the tens of thousands. A recent study by Dr Lisa Littman suggests that detransition is under-reported and needs to be comprehensively studied to develop alternative, non-invasive approaches to treating gender dysphoria for young people. In this interview, detransitoner Ritchie Herron describes the catastrophic effects of his gender surgery which he says was "the biggest mistake of my life." On GB News, detransitioners Keira Bell and Ritchie Herron describe the lack of information they were given about the side effects of surgery and the pressure they felt under to agree to the recommendations of their doctors and therapists.

Everyone, including transgender people, has human rights as stated by the United Nations Declaration. Trans rights activists seek to claim extra rights that others don’t have, for example, to be able to keep secret a previous identity, or to be able to prescribe how language is used. Gay rights concern the right for consenting adults to have same-sex relationships and to have the same rights as heterosexual people. Trans rights, on the other hand, seek the extra right to self-identify into a protected group and be eligible for that group’s special discretions. Gay rights accept that there are two sexes, the distinct reproductive capacity of each, and do not denmand medical or surgical treatments. Trans rights reject the science of sex and claim that what a person thinks and feels is of most importance and that those thoughts and feelings can literally transform a body into the opposite sex. Trans rights dictate that everyone adheres to the trans way of interpreting and describing gender and sex. Trans rights demand medical and surgical treatment as a right and put transgender people, often young people influenced by social media, onto a conveyor belt of lifelong medicalisation. Gay rights do not require others to forfeit anything or demand fundamental changes to everyday language. Trans rights insist on the forfeiture of single sex spaces, sports, scholarships, representation, and even language. Trans rights push to censor the words used to describe women and women’s bodies – foundational words like ‘mother’ or ‘woman’ – and replace them with dehumanising words like ‘birthing parent’, ‘bodies with vaginas’ and ‘people who menstruate’. Transgender activists are undermining gay rights by claiming same-sex attraction is really same-gender attraction and by denying biological reality. Without biological sex, there is no homosexuality.

Until very recently, everyone would have answered this question with the perfectly clear dictionary definition: “adult human female.” However, in the past few years many people have become so caught up in gender ideology, or so afraid of being labelled transphobic, that they find the question impossible to answer. Despite a large number of politicians, journalists, a US Supreme Court Judge nominee, and various celebrities being unable to define the term and tying themselves in knots in the effort, every woman remains, and always will be, an “adult human female”. A female is born with the reproductive anatomy to produce eggs and bear young. Even if a female’s reproductive anatomy is incomplete or inactive, or she has had a hysterectomy, every adult human female is still a woman.

Intersex should more correctly be called DSD - differences in sex development. It is a medical condition not a gender identity and therefore has nothing in common with the trans rights socio-political campaign. Intersex conditions have been co-opted by trans activists in an attempt to try to prove that sex is on a spectrum. Whether a person is male or female is the result of a complex interaction of chromosomes, genes, and hormones, and this intricate process does not always go fully to plan. In other words, some humans are born with differences in sex development (DSD). This in no way counters the fact that in the vast majority of cases – 99% – the complex process does work and humans can be reliably classified as male or female in the first trimester of pregnancy. Sex is not on a spectrum. The only time sex is “assigned” at birth is in the very rare cases where the baby’s physical genitalia are not immediately classifiable as male or female. In all other births, sex is observed and recorded at birth. A small number of people are born with ambiguous genitalia or internal organs that don’t match their chromosomes. Claims that 1.7% of people are intersex (the same as the incidence of red hair) have been inflated by including in the count those with conditions such as Klinefelter or Turner syndromes. People with these syndromes are always male (Klinefelter) or female (Turner) who have chromosomal abnormalities; they are not intersex. To retain its proper meaning, the DSD label (intersex) should be restricted to those conditions where chromosomes and genitalia are inconsistent and not classifiable as male or female. Using that criteria, the prevalence of DSD is about 0.018%.

A recent Statistics NZ Household Economic Survey of more than 31,000 people found that 4.2% identified as LGBT+ of which 0.8 % were transgender or non-binary. Rainbow community leaders expressed surprise that the number wasn’t higher and thought some people were unwilling to disclose their identities. The same questions will be asked in the 2023 census. Having the correct statistics for transgender people is important so we know how many people are affected by transgender issues and also how much resource should equitably be allocated to their specific needs.

Not any more. Gender dysphoria is a well-documented psychological condition that used to mainly affect men. Hormone and surgical treatments were devised to assist adult men and a ‘watchful waiting’ approach was taken for young people with gender dysphoria because approximately 80% come to accept their biological sex as adults. In the past twelve years two major changes have happened: Firstly, there has been an exponential rise in the number of children and teenagers attending gender transition clinics around the Western world. In the UK, over the ten years from 2009 to 2019, the increase was more than 1,400% for boys and more than 5,000% for girls, meaning girls are now far more likely to identify as transgender than are boys. Very high rates of autism, psychiatric disorders and a history of trauma had often been diagnosed in these patients before they announced they wanted to change gender. Secondly, many transgender people are claiming a new gender identity without a diagnosis of dysphoria and sometimes even without intending to have any hormonal or surgical treatment. Because of these changes, “transgender” is now an umbrella term that does include some people with diagnosed gender dysphoria, but also many people who are simply non-conforming to gender stereotypes or who like cross-dressing.

Counting Ourselves, a frequently quoted NZ survey of 1,100 trans and non-binary people, reported that 71% of the respondents disclosed psychological distress and 56% had thought about attempting suicide in the past 12 months, with 37% having attempted suicide at some time, but there are serious flaws in the report’s methodology and questions. These statistics are repeatedly given as irrefutable fact but Counting Ourselves, and other similar surveys, are not a random sample of a population and cannot be verified against a control group. Further, asking respondents to self-report attempted suicide is known to overestimate the rate. The report itself says “our use of nonprobability sampling means that the generalizability of our results to the wider transgender population in Aotearoa/New Zealand and beyond should be interpreted with caution”. Suicide rarely has one cause and it is difficult for studies to extricate gender dysphoria from other factors. Although trans-identified people do suffer worse mental health than the general population, they also have higher rates of anxiety, depression, trauma, and neurological conditions that usually predate the trans identity. Most surveys do not take into account pre-existing conditions or co-morbidities and simply attribute the poor mental health to being transgender. Exaggerated suicide statistics are being used as a form of emotional blackmail (“Better a live daughter than a dead son”) to push parents, clinicians, and others into acquiescing to irreversible treatments for minors. The UK Gender Identity Development Service states on its website: “The majority of the children and young people we see do not self harm, nor do they make attempts to end their own life. Although there is a higher rate of self-harm in the young people who are seen at GIDS compared to all teenagers, it is a similar rate to that seen in local Child and Adolescent Mental Health Services (CAMHS).” There is little evidence that medical transition decreases suicidality or that puberty blockers are necessary to prevent suicide. A long-term Swedish study found that post-operative transgender people have “considerably higher risks for suicidal behaviour”.

The Conversion Therapy Practices Prohibition Act will come into force in 2023 and is intended to protect all LGBTQIA+ people from conversion therapy, which is defined as any practice that tries to change a person’s sexual orientation or gender identity. However, including gender identity in this Act may prevent young people from receiving the most appropriate care for their gender dysphoria. Although health practitioners are permitted to take an action if they consider “in their reasonable professional judgement it is appropriate” it is not clear whether parents and counsellors will have the same protection. Under threat of possible prosecution, some may feel forced to affirm a transgender identity instead of investigating other possible causes of gender dysphoria or delaying treatment while waiting for the patient to mature. The UK government has delayed a similar bill after the Equalities and Human Rights Commission urged careful and detailed consideration of its significant and wide-ranging implications. After announcing in January 2023 that a bill banning conversion therapy was imminent, by May 2023, the UK government has not yet introduced it.