Ryan T. Anderson has done it again. With the release of When Harry Became Sally, he has produced another timely, thoughtful, and important book that weighs into one of the most divisive and pressing issues of our day.

Anderson is careful to make a distinction between activists who are pushing a transgender ideology on the nation, and individuals who experience gender dysphoria. He expresses genuine concern and compassion for people—and especially children—who have gender dysphoria. He rightly recognizes that most people with gender dysphoria are not activists, but simply trying to find meaning and happiness in life, like all people.

And yet, Anderson is uncompromising in his critique of transgender ideology. In fact, he wrote the book because he couldn’t shake the painful stories he heard of people who had detransitioned from have a transgender identity back to their natural sex. He wanted to give them a voice, and to prevent more people from suffering in the same way.

Transgender Ideology

How does transgender ideology contribute to the suffering of people with gender dysphoria? Anderson cites numerous recent studies that found significantly elevated rates of suicide and other mental health problems among transgender adults, even after hormonal and surgical treatments. And the negative outcomes cannot be blamed on a hostile culture, as activists often claim, since these findings are found in some of the most “inclusive” cultures in the world (p. 93).

Anderson asks: If this is what the science reveals, shouldn’t we be much more cautious about encouraging people to permanently change their bodies and to undergo a sex change? Shouldn’t we find and promote healthy alternatives to transitioning?

This is the approach of Paul McHugh, Harvard-trained professor and chair of psychiatry at John Hopkins Medical School. At his direction, John Hopkins stopped performing sex change operations in 1979. Why? The answer is simple: The lack of medical evidence such operations brought positive health benefits to patients. Rather than following a cultural fad, or bending to political pressure, both Anderson and McHugh believe we should follow the scientific data and act in accordance to what brings genuine well-being to people with gender dysphoria.


Since I am an apologist, the most interesting part of the book to me was the section called “Transgender Contradictions” in chapter two. Anderson notes the many contradictions at the heart of transgender ideology (again, he is speaking of activists and their claims). Consider four examples:

  1. Many activists claim that the “true self” is something beyond the body, and yet they embrace the philosophy of materialism in which only the material world exists.
  2. They promote a radical individualism in which people can be whatever they want and define truth as they desire, yet simultaneously try to force acceptance on society as a whole.
  3. They claim that feelings are sufficient for a biological woman to be a man. But why can’t feelings trump biology in other realms such as age, height, and race?
  4. Gender identity is claimed to be biologically determined and immutable, and yet also self-created and changeable. Which is it?

Anderson lists many other contradictions. I don’t want to “steal his thunder,” so you will have to get the book to read the rest. But he goes to great lengths to show the scientific, philosophical, and legal contradictions at the heart of transgender ideology. And as I said earlier, he does it with genuine compassion towards those with gender dysphoria.

According to Anderson, if we truly want to help people with gender dysphoria, we also need doctors and therapists who can help people find healthy alternatives to transitioning, scholars and therapists to challenge the misdirection of the academy, pastors to teach their flocks the truth about human nature and to lovingly offer pastoral care, as well as lawyers and politicians with an accurate understanding of what is at stake.

This is a timely and important book. I could not recommend it more highly.