Brianna Wu's Dire Warning For Transgender Activists: "The Tactics We Are Using Are Failing." (Printed Q&A Version)
Brianna Wu's Dire Warning For Transgender Activists: "The Tactics We Are Using Are Failing." (Printed Q&A Version)
My conversation with Brianna Wu, a survivor—of Gamergate, addiction, and youth gender dysphoria—who has charted a unique course down the center of the most combustible social issue of our time.
Note to readers: Yesterday, I put out this interview as a podcast. This is a printed Q&A of my conversation with Brianna Wu.
Brianna Wu is a survivor. She survived a harrowing battle with addiction. She survived years of horror as one of the central targets of Gamergate. And she survived a youth tormented by severe gender dysphoria.
Today, this transgender phoenix is executive director at the progressive political action committee Rebellion PAC and a democratic operative. She is harnessing the strength and fortitude that got her through so much turmoil and torment to become a leading, signature, and controversial voice in the trans rights movement.
To cite the reality-TV adage, I’d say she’s not here to make friends, given how unafraid she is to lodge unpopular arguments into the melee over trans health care. But in fact she is here to just that. Blessed with a winsome personality and a charming, devil-may-care attitude toward speaking her mind (think a sassy, glammed-up version of Rachel Lynde from Anne of Green Gables), she told me that one of her primary goals is to build bridges between warring factions as this combustible civil-rights issue faces a watershed moment.
I recently spoke with Ms. Wu for an article I published today in the New York Post, “The Trans Turning Point,” in which I write about how the walls are closing in on pediatric gender medicine in the U.S. Do check out my article here. And check out my tweet thread about the article.
Ms. Wu had so many interesting points to make, and she kept stressing how much she hoped certain things she said would make it into my article. So I’ve included the entirety of our conversation in this Substack.
Charting a delicate—and rare—center path, Ms. Wu is unsparing in her criticism of what she characterized as trans activists’ excesses and radical demands. She blames those forces, in part, for the political backlash that she said now leaves her having to fight to defend her own humanity as a trans woman every day.
In addition to becoming more vocal about being transgender, Ms. Wu, who is in her late 40s, recently went public with the fact that she has a degenerative condition that is steadily stealing her voice. Over time, her vocal chords will lose their strength until she is rendered silent.
Until that time, Ms. Wu, who lives in the Boston area with her husband, is trying to make the most of the voice she does to speak out and to call for a course correction in trans rights.
Below is our interview, which has been lightly edited for clarity and length.
If instead you want to listen to a podcast version of the interview, click here:
Benjamin Ryan: Let’s look to the future for pediatric gender medicine. You really set yourself apart as somebody from within the trans community who is critical of the prevailing dogma with respect to this type of gender-transition treatment. How do you see the consequences or repercussions of the overall politicalization of this subject?
Brianna Wu: Something that makes me different than a lot of the people commenting on this is: Look at my public comments. My mission is trans dignity and my mission is trans health-care access. The best care for trans people is always going to be at the core of that. And that’s why it’s so dismaying that so few of my friends in the political space seem to have come to the conclusion that the tactics we are using are failing.
Is it that trans activists went too far? Or is it that the Republicans needed someone to go after and we were a target. Both those things are true. But the impulse we have to blame everything on the right wing is so convenient. And it is not true. And the reason these attacks on us are having salience is because they have a point that makes sense to normal people.
“The tactics we are using are failing…The impulse we have to blame everything on the right wing is so convenient.”
We have a choice to make as the trans community. We can put our fingers in our ears, and pretend this is not a problem and stay on this course. And the outcome of that is going to be: Adult or child, you will only be able to transition in blue states. And that’s the truth. Or we can wake up, we can try to meet people halfway. We can try to address the things that are broken, particularly in pediatric gender care. And we can go forward. And I really hope it’s the latter. But, judging from the way trans Twitter behaves, I suspect it’s going to be the former.
Do you really think its inevitable that such restrictions on adult trans care are inevitable in red states nationwide?
Yes. The entire project is under scrutiny. I really think it comes down to WPATH [the World Professional Association for Transgender Health] and an expansion of what trans means that the science cannot justify. These providers have decided that you [as an adult] could walk into a Planned Parenthood and get on testosterone without any therapy. It is WPATH that decided that non-binary people should be able to get gender-affirming surgery—something I am deeply unconvinced is helpful. The truth is, our mission has expanded, not because of politics, not because of science, but because of politics. And because of that, a correction is largely inevitable, unless we are willing to own up to some of these excesses.
What about the credibility of the LGBTQ groups?
LGBT groups are very used to staying the course on attacks by the right wing. And generally speaking, it is a good course of action. But there is a huge difference in staying the course on a social issue like gay marriage and staying the course on health-care treatment [about which] it’s very clear that it’s not serving everyone that signs up for it. And I am worried that we’ve gotten into this mode of never listening to criticism. And I think it’s causing us to act in ways that are not going serve the community.
But will there be accountability? Will HRC raise less money?
I think for normal Democrats, there was a Kamala Harris event with a bunch of musicians a few days ago. And one of the things was you had a celebrity sitting there talking about non-binary trans people and how they needed dignity. And I was sitting there listening to it and it was so clear to me that they were just repeating a line without really understanding what they were talking about.
“People in the middle, I think they’re hearing these stories from the right wing and they are making sense to them. And unfortunately, there is no one out there that’s on the left, that is a Democrat, that is making the case for more caution with this. And so I think we’re really walking face first into a cultural firestorm.”
I think for the moment, it is safest socially for people on the left to just go along with every single bit of it: self-ID, non-binary, surgeries for everyone. You get so socially punished for saying otherwise. What I think is happening because of this is people that aren’t in that kind of social pipeline, people in the middle, I think they’re hearing these stories from the right wing and they are making sense to them. And unfortunately, there is no one out there that’s on the left, that is a Democrat, that is making the case for more caution with this. And so I think we’re really walking face first into a cultural firestorm.
What are the elements of that firestorm?
I think that you’re going to continue to hear these stories of detransitioners. If trans people think those stories are bad today, we’re going have 100 times more in five years. And I think they’re going continually go in front of legislatures and make that case.
Here in Massachusetts, we have left wing groups that are organizing in schools to push back on some of this social transition done without parents’ permission. I think there’s going to be a growing animosity with normal people. And I think it’s going to have political failings. I think unfortunately, adult trans people like me are going to be a casualty of that.
Do you feel that now?
Yes.
What are some examples of that happening to you?
I have to defend my humanity every single day—in ways that I didn’t five years ago. The truth is, we are re-litigating things I thought were settled, like my ability to go use the bathroom. It’s really unfortunate, because,we are on the chopping block in ways I think a lot of trans people are just not aware of. Because they don’t follow their local politics. They don’t go to their local school board meetings. Their politics are online so they don’t understand the power of this Death Star that is being constructed.
And the Death Star is…?
The Death Star is this organized effort to push back on trans people. And some of this is legitimate. Some of it is about health care. But part of it is just good old fashioned transphobia. And there’s an organized effort to push trans people out of public life. And again, I feel very strongly about this: We can either we can either wake up and course correct, or we can lose a limb. Those are the choices.
“We can either we can either wake up and course correct, or we can lose a limb.”
I think we can say the sports issue is distinct from, say, bathrooms, because of the science of sports competitiveness. If a trans person goes into a bathroom, does that really increase somebody’s risk of harm? They might be like uncomfortable, and that’s one thing that is worth discussing. But is there really any evidence that sexual assaults are, say, rampant because of the policy?
It doesn’t just have to be sexual assault. One of my problems with the way trans activists have behaved is: When I transitioned 20 years ago, the Benjamins the Harry Benjamin International Gender Dysphoria Association], which were the precursor to the WPATH, gave you a set of steps to go through. And one step led to the next. Go get therapy. If the therapist will work with you, then you can get on HRT [hormone replacement therapy, i.e.: cross-sex hormones]. Get on HRT, take some time, see if you like it. That leads to RLE [real-life experience living as the opposite sex]. Go into RLE see if you can have a job. If you can hold down a job for a year, maybe you can get GRS [gender-reassignment surgery], if you go talk to these professionals and they agree with you. Every step required something from the community, and it gave you a next step. So it put you on a path to socialize you.
You’ve spoken a lot about assimilation, that you really believe that’s important.
Yes.
So a lot of people will push back on you: “Why do we have to assimilate?”
A hundred percent. But my point is: If you're talking about the bathroom situation, the reason it is more chaotic today is, I don’t agree with you that a woman being uncomfortable in a bathroom—that's a problem. That’s a real political problem.
The trans community used to have more sense in how we did this. Twenty years ago, there were women that didn't have GRS. Do you think we advertised that we were going into women’s locker rooms before you’ve had surgery? No. It was a community secret. We showed some judgment, because we want to go about our lives.
“Coexistence requires compromise. And trans people are asking for some compromises from the wider community. But this set of activists is not willing to give anything up in return. And that’s not reasonable.”
Today, those same activists are bragging about this, and acting as though they’re entitled to this. Coexistence requires compromise. And trans people are asking for some compromises from the wider community. But this set of activists is not willing to give anything up in return. And that’s not reasonable.
It’s common sense that if you’re somebody who appears to be a woman unless the shorts are off, if your penis is out the women’s locker room, people are going to get upset. And maybe you should change in the stall, just to keep the peace.
That’s right. It’s crazy. It’s insane.
That’s nothing against that person’s body. But how do you think people are going to react?
It should be important to you if you’re a woman that women around you feel safe. That is a very fundamental rule of women spaces. And if you don’t understand that, penis aside, you should not be in that space.
That’s just an everyday part of being a woman, the knowledge that if some man came up to you that you wouldn’t be as strong as them. And you have to live with that all the time, because a lot of men cannot be trusted to behave themselves.
One hundred percent. But really looking at the political project, I feel really, really strongly that things are dire for us [trans people] and it’s going to continue to get worse. I think it’s really easy to put the blame on the activists. But the truth is: Trans people have always had crazy activists. The real blame in my assessment is WPATH. And it’s HRC [the Human Rights Campaign]. The truth is we have these [medical] providers with the best of intentions who have taken away the safeguards. These safeguards, we try to talk about them like they’re oppression. They’re not. They’ve kept the community safe by keeping standards. And it does not serve trans people to build a system where cis [cisgender, i.e.: non-trans] people get our health care. So I really put the blame on the activists with WPATH.
“These safeguards, we try to talk about them like they’re oppression. They’re not. They’ve kept the community safe by keeping standards.”
When you said you said “get our health care,” what did you mean exactly?
Chloe Cole is a fantastic, example: Someone who is not trans, clearly, walked into Planned Parenthood [Cole was actually treated by Kaiser Permanente and is now suing them], never saw a therapist.
She was misdiagnosed.
Correct
She got the treatment for the wrong patient.
That’s right. It does not serve trans people to build a system of health care where the Chloe Coles get it. We need to build a system with safeguards where we get it, and that the public can have confidence that tax dollars are going into it that are leading to good outcomes.
You need to have some sense about this.
Yeah. There are so many similarities between trans people and libertarians, in the sense that libertarians have this dream world they’ve created, where you don't need driver’s licenses, you don’t need a health care system. And it makes its own internal logic. But of course, it’s completely impractical in the real world. I think that is fairly analogous to where trans activism is today.’
“There are so many similarities between trans people and libertarians… But of course, it’s completely impractical in the real world. I think that is fairly analogous to where trans activism is today.”
Some libertarians, maybe they’re just real neoliberals in that they believe in free markets without much regulation. But some of them are just cuckoo—like just go away and read Thomas More and don’t come back!
If you’re talking about designing a health care system, the science and the realities of providing care has to come first and not the politics. And that is where WPATH went off the rails, in my view. You know, [WPATH president] Marci Bowers did my [gender-reassignment] surgery. I love Marci Bowers! I am so thankful for her. She had a direct influence on my life and made it drastically better. I’ve never had a second of problem with the surgery she gave me. So when I saw Marci Bowers become president, I was thrilled. And I’ve just become more and more concerned day after day. I frankly thought she was smarter than that. So it’s very surprising.
In the WPATH files, you recall that she says in that one message that it’s verboten to even discuss detransitioners. She acknowledges that this kind of silence is a problem. She said to me when I interviewed her in February that suicide death has never been a good metric for the efficacy of gender-affirming care for minors. So she will say things that are more nuanced. But she’s a part of the machine. And she’s not exactly remaking it from the top. So it is her responsibility. She’s the front woman.
This is the trans community, right? You see the price I pay every day for advocating for a more moderate pathway. Every incentive is there to go along, and they get crazier and crazier.
I think people see you as having been stealth all this time, and they discredit you for that. Would you agree?
Yeah, I think so. I don’t know how stealth I was. I just didn’t talk about it publicly. I didn’t want to be the focus of my career.
I relate because, even though my career is a very gay-focused, it was never my intention to, like, lead with gay. Maybe part of it is still internalized homophobia. But I don’t want to walk around with a big advertisement. I don’t want to walk in a room and people say, “Did a rainbow just walk in the room? We sensed him coming, he smells like glitter.”
You do smell like glitter, that’s very true.
To your point earlier: Marci Bowers is great for the right patient. And we need to have systems that can identify the correct patients before Marci Bowers goes into the operating room.
I was really surprised to take a deep look at the DSM-V and see that the criteria for gender dysphoria has gone to only two out of those six [criteria].
The DSM-V replaced gender identity disorder with gender dysphoria in 2013
I was diagnosed on the DSM-III. It’s just very different today. I think directionally, there’s been a tendency to lower the standards [for diagnosing gender dysphoria]. Lower the standards and loop more and more people inside of this. And I think all the evidence from what I can see is this does not seem to be leading to better outcomes for people. Especially when surgery is in the mix, I actually think we should be raising the standards. We should be asking more questions. So I think this mission that was well-meaning to expand access, I think it is not serving the communities.
Parents deserve to know that many of the assumptions and the science that their children’s health care is based on is based on a cohort that is like me. It is science from a long time ago. It’s men, biological boys that felt like they were girls from a very young age; had very, very strong clinical symptoms—according to an older, tougher standard.
But that’s not the trans community today. The number of FTMs [female-to-male trans people] has exploded. And these are not the same phenomena. The number of non-binary people has exploded. And frankly, we’re seeing numbers of people with autism and other comorbidities like social anxiety disorder. These have exploded.
If I had a child, even as someone who has happily been a woman for 20 years, even as someone who feels as strongly as she can that transition saved my life, if I had one of these children, I would have extreme caution about going forward with this assumption.
And it’ll be especially interesting in your own situation because they might be looking to you for, cues. Like, “That’s the way that Mommy is, but that doesn’t mean that’s the way you are.”
That’s right. 100 percent.
You see those families where, like, everyone’s trans.
It seems statistically unlikely to me.
And that’s fine, there’s nothing wrong with if you want to identify the other sex. But once you get the health care situation into the mix, the ethics of it change.
I think if children are involved, it changes. I’m being truthful when I say I barely survived childhood.
You barely survived a lot. You had all the drug use.
That drug use is 100 percent the result of untreated gender dysphoria in childhood. So my message is: I’m really hoping that we can look at this critically and find a clinical path to get these kids the health care that they need. But then, we’re not going be able to develop a clinical criteria that is going to withstand scrutiny if we stay on this course and stick our fingers in our ears and pretend there are no problems. We need serious researchers who have trans dignity as their very top mission out there asking for NIH grants to develop a better clinical protocol.
“We’re not going be able to develop a clinical criteria that is going to withstand scrutiny if we stay on this course and stick our fingers in our ears and pretend there are no problems…What is the difference between someone like you that just grew up gay, and someone like me? How can we really figure that out in childhood? Serious people need an answer about that.”
What is the difference between someone like you that just grew up gay, and someone like me? How can we really figure that out in childhood? Serious people need an answer about that. So if we’re serious about helping these kids, we need to be a lot more humble about what we know and we need to be a lot more transparent with parents.
What do you say to someone who says, “It sounds to me, Brianna, like what you’re doing is you’re trying to narrow the boundaries of who is and is not trans to basically limit them to people exactly like you. And then that’s selfish.”
I would say that gender dysphoria is a scientific construct. And I have in good faith looked at the science behind this effort to expand it. And the evidence is very weak. Like if you showed me a study tomorrow that showed that these non-binary people that end up getting surgeries, that they have better long-term health care outcomes, I’d change my opinion instantly. But it’s not what I see. It’s not what I suspect is, true. So we need real science to figure this stuff out.
I think these FTMs are the ones that are constituting the bulk majority of detransitioners. And testosterone is so powerful that I don’t see a very compelling case to make that decision before kids are 18. I almost think you could take them off the board. Because look at the science. The case is so much stronger MTFs [male-to-female trans people]. Because testosterone does do permanent damage to our bodies, as these detransitioners are finding out. I think there’s a way to thread that needle. But we need better science.
And frankly, trans people need to be a lot more willing to fund science and trust science, even when it comes to conclusions that may not prove what we want to believe is true.
Testosterone has consequences. I feel pretty strongly estrogen gives you a richer emotional life, but that’s just my opinion.
I’m trying to get this message out there to the public : My core mission here is dignity. And I think something’s gotta change.
I am an independent journalist, specializing in science and health care coverage. I contribute to The New York Times, The Guardian, NBC News and The New York Sun. I have also written for the Washington Post, The Atlantic and The Nation. Follow me on Twitter: @benryanwriter. Visit my website: benryan.net
I'm not sure why this substack doesn't have more followers. Actually great reporting. Fair, science based, etc. Keep it up.
Thanks for this.
I must note, though, that Wu is considerably compromised on the topic of accountability. In 2021, Wu accused Jesse Singal of "wildly unethical behavior" and claimed to have "receipts" that proved this.
https://x.com/BriannaWu/status/1371452139856392196
Three years later, she has never specified the nature of this behavior, nor has she produced any of these receipts that she claims prove it, despite an offer of thousands of dollars to a charity of her choice:
https://x.com/kittypurrzog/status/1371540333301932038
Whatever her problem with Singal, Wu is guilty of harassment similar to that whick she herself has received, which you'd think would make her more mindful and perhaps more responsible about making accusations. That doesn't make anything she has said here wrong, but it certainly puts a different light on her credibility.