In June of last year I published The Persistence of Medical Atrocities: Lobotomy, Nazi Doctors, and Gender Affirming Care. In addition to comparing gender affirming care (GAC) to lobotomy in that essay, I compared GAC to female genital mutilation (FGM). Concerning the latter, the federal government of the United States banned FGM as part of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996. In 2021, the law was strengthened with the passage of the STOP FGM Act of 2020, increasing penalties and expanding jurisdiction to cover more situations, including acts performed outside the US that involve US residents. Moreover, FGM is illegal in many US states, with laws that provide additional penalties. The mutilation of girls and women, as well as boys and men, and that is what GAC is, should be banned across the United States and its territories. The double standard in this case is very troubling.
What I will say next will become significant when I turn to President Trump’s executive order of January 28, 2025, Protecting Children from Chemical and Surgical Mutilation. I want to return to the matter of lobotomy, a medical practice that was largely and quietly discontinued over a lengthy period of time, and contrast that with the prohibition of female genital mutilation (FGM). The prohibition on FGM contrasts sharply with the historical acceptance of lobotomy, despite both involving invasive and often non-consensual bodily harm. FGM, widely condemned as a human rights violation, has been outlawed in many countries due to its irreversible physical and psychological damage. This is also true of lobotomy in several countries across the globe. Even the Soviet Union banned lobotomy, making it one of the first countries to do so, proclaiming in 1950 that lobotomy was harmful and inhumane. Soviet psychiatrists criticized the procedure for its severe side effects, including deterioration in cognitive function and disorganization of the personality.
This stance stands in stark contrast to the widespread use of lobotomies in Western countries, particularly in the United States and Europe, during the mid-20th century. Lobotomy was widely practiced throughout the mid-twentieth century, often without patient consent, including on children who cannot consent due to their immaturity. Although lobotomies were eventually abandoned due to advancements in psychiatric treatment (I will leave the problematic character of these treatments to the side for this essay) and ethical concerns, they were never explicitly prohibited in the same legal and moral framework as FGM. This discrepancy highlights how societal and medical perceptions shape the regulation of bodily interventions, often influenced by cultural, gendered, and institutional biases. A key institutional bias comes in the corrupting force of the profit-motive, a force that drives the medical-industrial complex. The profitability of GAC overrides the same ethical standards that led to the eventual discontinuance of the lobotomy, the latter not nearly as profitable. Given the power of this corrupting force, it cannot be left to the medical-industrial complex to act on their obligation to medical ethics.
FGM is a deeply entrenched patriarchal practice that perpetuates the subjugation of girls and women by enforcing harmful beauty, purity standards, and gender stereotypes. The severe physical and psychological consequences, including chronic pain, childbirth complications, and trauma, underscore its oppressive nature. In the past, progressives were supportive of the prohibition on FGM, viewing the practice as a form of gender-based violence that violates the right of girls and women to live free from a harm caused by gender ideology. I want to make this clear: FGM is a practice governed by a gender ideology that see physically altering the body of girls and women as necessary to bring their bodies into alignment with the stereotypes of a patriarchal society. Progressives argued that cultural traditions cannot justify practices that inflict harm and reinforce gender stereotypes. I don’t see any distinction between the practices of FGM and GAC. Both accomplish the same thing and are motivated by parallel ideologies, not just in form but in substance. What happened in the case of GAC? When did genital mutilation become okay? Why the double standard?
I have explained this matter on Freedom and Reason. I document how it happened in Gender and the English Language. Why it happened is analyzed in several other essays (see, e.g., Fear and Loathing in the Village of Chamounix: Monstrosity and the Deceits of Trans Joy). I will leave the reader to those and other essays. Right now, I want to put on my sociology hat and discuss the power of culture and ideology in normalizing extreme and harmful action against girls and women.
From a sociological standpoint, cultural traditions refers to the beliefs, norms, and values that shape perceptions of reality and reinforce systems of power. Culture functions as a tool for maintaining dominant ideologies by normalizing certain worldviews while marginalizing others. Through institutions like education, media, and religion, cultural narratives legitimize social hierarchies while socializing individuals into accepting, often uncritically, beliefs, norms, and values that make likely certain ends, making those ends appear natural and inevitable, even necessary. This process influences everything from economic behavior to gender roles, dictating what is considered acceptable or deviant. Culture is thus not just a reflection of society but an active social force that delivers and perpetuates ideology, shaping how individuals understand their place in the world and interact with power structures. For progressives, GAC is acceptable while FGM is deviant, despite the fact that both are instantiations of genital mutilation demanded by ideology. Gender ideology and queer praxis underpins the double standard and misdirects public consciousness to uncritically accept one while rejecting the latter on reason. This is an instance of what George Orwell in Nineteen Eighty-Four calls “doublethink.”
If the principle that underpins the prohibition of FGM—the rejection of harmful cultural practices—were taken seriously by rational minds, then these same principles must be consistently applied across all forms of extreme body modification, including genital mutilation. Just as FGM has been recognized as a violation of human rights despite its cultural justifications, other medical interventions that permanently alter bodies in ways that reinforce ideological norms should be subject to the same scrutiny. GAC is driven by gender ideology, a set of beliefs, norms, and values that shape perceptions of reality and refinance systems power—while generate large and sustained profits for the medical-industrial complex. Culture has the power to shape what is considered abusive or ethical, and it should not be allowed to obscure the fundamental question of whether a practice truly serves individual well-being or simply reinforces existing power structures. The prohibition against FGM defies cultural demands, putting health and safety of girls and women above ideology. A society committed to protecting vulnerable individuals must critically examine all medical interventions through this lens, regardless of the prevailing cultural or political narratives that seek to legitimize them.
To this end, President Donald Trump signed an executive order doing just that, establishing a federal policy prohibiting the funding, promotion, and support of gender transition procedures for minors under 19 years old. It accurately defines these procedures as “chemical and surgical mutilation,” including puberty blockers, hormone treatments, and gender-affirming surgeries. The order asserts that such interventions cause harm and lack scientific integrity, the lack of which I demonstrate in numerous essays on this platform (more than this, disconfirmation of its claims), instructing the Department of Health and Human Services (HHS) to review and amend policies that rely on guidance from the World Professional Association for Transgender Health (WPATH). I discuss the WPATH in the essay “Fear and Loathing in the Village of Chamounix” cited above. Crucially, Trump’s order mandates the defunding of medical institutions that provide these treatments to minors by restricting federal research and education grants, research often aligning with WPATH assumptions.
There’s more. The Secretary of HHS is directed to take regulatory actions limiting access to gender-affirming care for children, including revising Medicare and Medicaid standards and rescinding previous federal protections. The order further directs the Department of Defense to exclude such procedures from TRICARE coverage, the Office of Personnel Management to ensure federal employee health insurance plans do not cover pediatric transition-related treatments, and the Department of Justice to prioritize enforcement against practices it deems deceptive or harmful. It also calls for new legal avenues for individuals seeking recourse against medical professionals involved in gender-affirming care, including reviewing Department of Justice enforcement of section 116 of title 18, United States Code, and prioritizing enforcement of protections against female genital mutilation. It calls for convening states’ attorneys general and other law enforcement officers to coordinate the enforcement of laws against female genital mutilation across all American states and territories. It moreover targets state laws and policies that remove custody from parents who oppose such treatments.
There is more still, so I encourage readers to following the link and read the order themselves. I will conclude by noting that Trump’s decisive action in strengthening protections against harmful medical interventions reflects a commitment to safeguarding the rights and well-being of vulnerable individuals and those who cannot consent to having their bodies medically altered by an for-profit industry. By reinforcing the prohibition of female genital mutilation by extending similar protections to minors facing the irreversible medical procedures covered by GAC, the administration has prioritized ethics, human dignity, and science over ideological pressures. The executive order ensures that federal resources are not used to promote treatments lacking scientific integrity. Through strong regulatory measures and a clear stance against coercive medical practices, the Trump administration has reaffirmed the government’s role in protecting children from harm. This stance should be expanded to cover adults, as well. Nonetheless, the policy underscores a broader commitment to defending fundamental human rights and resisting cultural narratives that seek to normalize irreversible medical interventions on minors.
freedom and reason 