Two years ago, "Titania McGrath," whose
satirical Twitter account regularly skewers the ideological excesses of social-justice culture,
suggested that "we should remove biological sex from birth certificates altogether to prevent any more mistakes." The joke (obvious to those who follow the culture wars closely, but perhaps obscure to those who don't) was directed at gender activists who insist that male and female designations "assigned at birth" are misleading (and even dangerous), since they may misrepresent a person's true "gender identity" — that internally felt soul-like quality that supposedly transcends such superficial physical indicia as gonads and genitalia.
But the line between satire and sincerity has become blurry on this issue. Last Thursday, the
New England Journal of Medicine (
NEJM), widely considered to be the world's most prestigious medical journal, published an article entitled
Failed Assignments — Rethinking Sex Designations on Birth Certificates, arguing that (in the words of the abstract) "sex designations on birth certificates offer no clinical utility, and they can be harmful for intersex and transgender people."
The resemblance to Titania McGrath's 2018-era Twitter feed is uncanny. Two of the authors are doctors. The third, Jessica A. Clarke, is a law school professor who seeks to remake our legal system so as to "recognize nonbinary gender identities or eliminate unnecessary legal sex classifications."The very idea of "a dichotomous sex-classification system" is dubious, the authors believe. And even if such a system were preserved, they write, it should be based "on self-identification at an older age, rather than on a medical evaluation at birth." Sex designations on birth certificates, it is argued, "offer no clinical utility; they serve only legal — not medical — goals."
On social media, where the NEJM article has attracted nearly 6,000 (almost uniformly negative) comments, many readers expressed disbelief that such a piece would appear in the same storied academic journal known historically for definitive, groundbreaking scientific papers on such subjects as
general anaesthesia, the
discovery of platelets, and the clinical course of
AIDS. "I'm a pediatrician,"
wrote one Oregon-based doctor. "The growth curves for male and female babies are notably different. Am I to just give up on tracking normal growth and development?"
Comment: Lockdowns and mask mandates are driving people nuts. As tensions soar and frustration levels rise, expect to see a lot more of this.