Table of Contents

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Patient Zero


bad medicine


big medicine


coming for your kids


the politics of transgenderism


social contagion


the way forward

Patient Zero

To understand how we got here, it is helpful to revisit the “John/Joan” case, an experiment by the influential psychologist and sexologist John William Money. Its main subject, David Reimer, was a kind of patient zero for transgender children. Many aspects of this story prefigured things all too familiar in our time: the media’s role in promulgating and popularizing radical ideas, the involvement of the state—Money received funding from the National Institutes of Health (NIH) throughout his life—and the complicity of the medical establishment and healthcare companies.

Bad Medicine

Before the mid-1990’s, medical transition was still primarily reserved for adults. The truth about the John/Joan case was revealed in 1997, thanks to the work of Milton Diamond, an academic critic of Money, and Colapinto’s journalism. But that didn’t stop the tide that brought us to where we are today. The medical establishment today proceeds with the same resistance to reason and decency that characterized Money’s approach. Diamond said that some believed in the John/Joan case “almost as a religious entity,” and nothing would sway them of its success. No evidence could ever be sufficiently damning to change their minds, and damning evidence would be severely qualified or suppressed. As the political philosopher James Burnham wrote: “An ideologue—one who thinks ideologically—can’t lose. He can’t lose because his answer, his interpretation and his attitude have been determined in advance of the particular experience or observation. They are derived from the ideology, and not subject to the facts.” Unfortunately, Burnham’s ideologues, shockproof to external stimuli, are now in complete control of the medical establishment.

Big Medicine

When the formalism—the supposedly supporting “facts” of the matter—in which ideologues shroud the affirmative care model melts away, the very real world of power and profit remains. In a video from 2018 surfaced by journalist Matt Walsh, Dr. Shayne Taylor, a university professor and a physician at the Vanderbilt Clinic for Transgender Health, explained during a lecture how she convinced Nashville to get progressive on the issue. She highlighted that transgenderism is a “big money maker,” especially because the surgeries require a lot of “follow ups.” Taylor delivered these remarks the same year the clinic opened its doors. “These surgeries make a lot of money,” she said in the video. “So female-to-male chest reconstruction can bring in $40,000. A patient just on routine hormone treatment who I’m only seeing a few times a year can bring in several thousand dollars. . . . It actually makes money for the hospital.”

Coming for Your Kids

At USPATH’s inaugural conference in February 2017, audio recorded by an attendee and uploaded to the 4thWaveNow website reveals that a group of presenters argued for the necessity of setting the justice system upon parents who don’t want to go along with the transgender program after LGBT commissars have given them “every chance to learn, to grow, and they’re continuing to be part of the problem.”

The Politics of Transgenderism

The advocates of transgenderism like to present themselves as scrappy underdogs, fighting for the marginalized, but the amount of institutional support behind them is immensely well-funded and far-reaching.

In January, Sam Brinton was appointed deputy assistant secretary of Spent Fuel and Waste Disposition in the Office of Nuclear Energy. Before that, Brinton served as head of advocacy and government affairs at the Trevor Project, an LGBT nonprofit advocacy group. His appointment made waves when it was revealed that he has a history of publicly promoting deviant sexual behavior related to animal-role playing and BDSM. More importantly, the Biden administration cited research from the Trevor Project to support medical intervention for minors to change their gender. Setting aside the problems with the study itself, the AbbVie Foundation’s Form 990 from 2019, the latest year on file, shows a donation of $50,000 to the Trevor Project. So the White House cited a study produced by a nonprofit which has received thousands of dollars from companies that make drugs and medical products used in the gender transition process to argue in support of puberty blockers, hormone therapy, and sex-reassignment surgeries for children. No conflict of interest here, of course.

Social Contagion

Transgenderism’s endorsement across the spectrum among political leaders varies only by degree. And on top of the tremendous corporate and nonprofit backing it receives, it also enjoys full support from the culture—by which I mean the institutions that create and support and spread our common understanding of moral and legal rules and social codes of conduct, like schools, which have proven a vanguard of transgender ideology. In New York, for example, Drag Story Hour NYC—a nonprofit whose cross-dressing performers are invited to engage with children as young as three—has received $207,000 in taxpayer dollars since 2018 from city contracts for appearances at public schools, street festivals, and libraries. Nowhere is spared from this—from California to Texas and Wisconsin to Florida and Arkansas, staff in public and private schools all over the country expose children to LGBT ideology in general and transgenderism specifically. This often happens without parental consent or knowledge, as shown in the endless stream of videos and images republished from various social media sites by researcher Chaya Raichik, who operates the “Libs of TikTok” Twitter account. 

The Way Forward

Setting America on a better path, one in which the vulnerable are not encouraged to self-destruct and sickness does not subvert health, requires challenging key institutions that act as the engines of transgender ideology. For a long time, politics have been perceived as downstream of culture. But the fact that transgenderism and like ideologies have been imposed by a manifestly top-down approach shows that it is possible to change the culture through political action. It is possible, in other words, to do more than merely slow the tide.


By Pedro Gonzalez

Pedro L. Gonzalez is an associate editor at Chronicles: A Magazine of American Culture. His writing has appeared in The New York Post, The Washington Examiner, The Spectator, The National Interest, and elsewhere. He is the recipient of a Lincoln Fellowship from the Claremont Institute and a Haggerty-Richardson Fellowship from the Conservative Partnership Institute.

Sneak Peek


“Drive Nature off with a pitchfork, she’ll still press back, And secretly burst in triumph through your sad disdain.” —Horace

In our time, the so-called “affirmative care” model toward young people confused about their gender has dominated the intellectual, moral, and cultural climate. Heterodox perspectives on transgenderism invite scathing attacks imbued with religious fervor that, even if well-meant, impede constructive debate over the consequences of transition therapy pushed on younger and younger Americans. Indeed, the model itself is hardly ever interrogated and instead, the discussion centers on to what degree we should affirm and intervene as we attempt to keep up with demand, which has grown exponentially over the last decade.

In 2013, “gender identity disorder” was dropped from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), considered by many “U.S. psychiatry’s bible for diagnosing mental illness,” and replaced with “gender dysphoria.” The former described a pathology—something unacceptable to diversity and inclusion commissars—while the latter is more benign and “refers to the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender.” The DSM-5 also noted that adult gender dysphoria occurred at a rare rate of 2 to 14 in 100,000. Last year, however, a study published by the American Academy of Pediatrics suggested that the rate of transgender identification among America’s youth may now be as high as 9 in 100. Further still, an analysis published in June 2022 by the Williams Institute at the UCLA School of Law using federal data found that nearly one in five people ages 13 to 17 identify as transgender today. In terms of national and regional distribution, the highest percentage of youth who identify as transgender are in the Northeast, with the lowest percentage in the Midwest. The top five states with the greatest number of youth in this category are California (49,100), New York (34,800), Texas (29,800), Florida (16,200), and Illinois (13,700). While there is national variation, this is happening all over the United States.

But the pendulum has begun to swing in the opposite direction. Public exposure to transgender ideology and its advocates, particularly those in the education system promoting radical ideas about sex and gender to children, often deliberately without parental consent or knowledge, has led to increased public skepticism and outright anger. The attempts to indoctrinate children have personalized the issue for millions of Americans in a way that few issues do. 

This report is a broad but concise overview of the issue based on five Ws and one H: who, what, when, where, why, and how. The sheer immensity of what I call the “transgender leviathan” is, in some ways, unprecedented relative to the size of the group it claims to represent. The amount of money moving through corporations, nongovernmental organizations (NGOs), political action committees (PACs), and governments is staggering; the number of powerful individuals involved is myriad and includes Republicans and Democrats. It would be impossible to exhaustively list all the various entities involved in such a small space. Instead, this report highlights and provides background on key individuals, institutions, and organizations so readers can inform themselves on how we arrived at this point, where it might lead next, and why we must fight back. There are generally two motives driving the normalization of transgenderism: ideology and interest, or those who are true believers and those who merely see transgenderism as an avenue for increased profit and power. The result, however, is the same: a society that lives by lies, the undermining of the family, and a radical reimagining of the relationship between the individual and their body and the citizen and state.

In practice, puberty blockers are really more like transition accelerators. One might even call it the first phase of lucrative transgender “conversion therapy.” @approjectClick to Post …the starting point is often the classroom, where children are exposed to transgenderism or even transitioned behind their parents’ backs. @approjectClick to Post …gender-affirming medical treatments—puberty blockers, cross-sex hormones, and surgeries—should be outlawed for minors. Sex reassignments, in general, should be considered dangerous quackery. @approjectClick to Post