A civilization in a death spiral can no longer maintain the moral demands that kept it alive. Neither can it tolerate an ability to see things as they are. Coherent authority shrinks. In “The Triumph of the Therapeutic,” Philip Rieff put it well: The dying order “demands less, permits more.” No longer able to distinguish between spectacle and reality, it substitutes one for the other.

Of all contemporary spectacles, none is a clearer “sign of the times” than the transgender delusion. By embracing and promoting it, the mental health profession abandoned troubled patients to their symptoms. Instead of guiding patients past their distortions, clinicians now affirm them.

Consider Dr. Rachel Levine. A transgender pediatrician and professor of pediatrics and psychiatry at Penn State College of Medicine, he was Pennsylvania’s state health director from 2015 to 2017. He has been confirmed as the assistant secretary of Health and Human Services in the Biden regime. Rachel is the synthetic replacement for the preceding Dr. Levine.

The first Dr. Levine was a married man with a son and daughter. In his 40s, he decided to go on a gender journey. Still married, he set out to deny the evidence of his genetic endowment: the inevitable Y chromosome in each of his 30-40 trillion cells, including some 86 billion neurons plus multiple times more glial cells.

Were Rachel Levine a private person, an obscure man suffering anonymously the anguish of self-loathing, he would elicit compassion and concern. Courtesy might move any one of us to assent to the counterfeit and address him as the woman he strains to be.

Levine, however, is not a nameless sufferer seeking relief from personal distress, only wanting to get on with his life. He is a public figure, the highest-ranking transgender official in the United States, and one with the capacity to affect the well-being of others — especially children.

A Threat to the Children of Others

Levine advocates puberty blockers, thereby grooming even the youngest to deny the reality of their bodies. He supports life-altering surgeries although the great majority of youngsters outgrow their “dysphoria” after puberty.

Sympathy stops at the gate of the toxic narcissism of an influential man empowered to inflict irreversible harm on other people’s children. In effect, unsettled children serve as tools for normalizing what common sense recognizes as his own pathology.

Only we dare not say so. Under the new leftist regime, any suggestion — however nuanced — that transgenderism is an ideology rooted in mental illness is subject to reprisal. Standards of truth and morals by which behaviors are judged in a civil society have been reduced to the feelings of a sovereign self.

Increasing medicalization of the variety of emotional responses of sensitive people to the boundless stresses of the lived life is reflected in the ever-enlarging “Diagnostic and Statistical Manual of Mental Disorders.” It grew from 119 pages in 1969 to 886 pages in the fourth edition (the DSM-IV). The most recent edition, the DSM-V, is even larger still.

Clamoring to be Discovered

Science began leeching out of clinical practice when the word “gender” was plucked from the rules of grammar and applied to persons. The DSM, published by the American Psychiatric Association, is a moveable feast of culturally flexible diagnoses, some real, some the brainchild of their backers.

The term “gender identity,” absent from the first two editions in 1952 and 1968, slid into the lexicon in the 1970s. “Gender identity disorder” first appeared in the fourth edition in 1994. In 2013, it was removed from DSM-V and replaced by “gender dysphoria.” It also added, for the first time, a section on “gender dysphoria in children.”

“Gender reassignment” is the currently approved term because, in truth, sex change is impossible. There is no erasing that Y chromosome. It will not dissolve or somersault into a second X chromosome. Neither can we switch our natal gametes. There are only two: the female ovum or male sperm cell. There is no choice in the matter. By contrast, there is no cap on the number of genders clamoring to be discovered (New York City’s official tally is 31 — so far).

Follow the science? Only until science interferes with pronouns and ideological dogma. Then the experts in gender theory — the new gnosis — parachute in to enforce compliance with a psychiatric condition that refutes the facts of existence.

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