Katie’s latest reporting illustrates some of the most urgent elements of that threat. It focuses on how biological sex is being denied by professors fearful of being smeared by their students as transphobic. And it shows how the true victims of that denial are not sensitive medical students but patients, perhaps most importantly, transgender ones.

Today we bring you another installment of Katie Herzog’s ongoing series about the spread of woke ideology in the field of medicine. Her first story focused on the ideological purge at the top medical schools and teaching hospitals in the country. “Wokeness,” as one doctor put it, “feels like an existential threat.”

Katie’s latest reporting illustrates some of the most urgent elements of that threat. It focuses on how biological sex is being denied by professors fearful of being smeared by their students as transphobic. And it shows how the true victims of that denial are not sensitive medical students but patients, perhaps most importantly, transgender ones. 

Some of you may find Katie’s story shocking and disconcerting and perhaps even maddening. You might also ask yourself: How has it come to this? How has this radical ideology gone from the relatively obscure academic fringe to the mainstream in such a short time?

Those are among the questions that motivate this newsletter. We feel obligated to chronicle in detail and in primary accounts the takeover of our institutions by this ideology — and the consequences of it. 

So far, it has taken root in some of our leading medical schools. Some. Not all. But I’m left thinking: What state will American medicine — or any other American institution —  find itself in after being routed by this ideology?  

During a recent endocrinology course at a top medical school in the University of California system, a professor stopped mid-lecture to apologize for something he’d said at the beginning of class.

“I don’t want you to think that I am in any way trying to imply anything, and if you can summon some generosity to forgive me, I would really appreciate it,” the physician says in a recording provided by a student in the class (whom I’ll call Lauren). “Again, I’m very sorry for that. It was certainly not my intention to offend anyone. The worst thing that I can do as a human being is be offensive.”

His offense: using the term “pregnant women.”

“I said ‘when a woman is pregnant,’ which implies that only women can get pregnant and I most sincerely apologize to all of you.”

It wasn’t the first time Lauren had heard an instructor apologize for using language that, to most Americans, would seem utterly inoffensive. Words like “male” and “female.”

Why would medical school professors apologize for referring to a patient’s biological sex? Because, Lauren explains, in the context of her medical school “acknowledging biological sex can be considered transphobic.”

When sex is acknowledged by her instructors, it’s sometimes portrayed as a social construct, not a biological reality, she says. In a lecture on transgender health, an instructor declared: “Biological sex, sexual orientation, and gender are all constructs. These are all constructs that we have created.”

In other words, some of the country’s top medical students are being taught that humans are not, like other mammals, a species comprising two sexes. The notion of sex, they are learning, is just a man-made creation.

The idea that sex is a social construct may be interesting debate fodder in an anthropology class. But in medicine, the material reality of sex really matters, in part because the refusal to acknowledge sex can have devastating effects on patient outcomes.

In 2019, the New England Journal of Medicine reported the case of a 32-year-old transgender man who went to an ER complaining of abdominal pain. While the patient disclosed he was transgender, his medical records did not. He was simply a man. The triage nurse determined that the patient, who was obese, was in pain because he’d stopped taking a medication meant to relieve hypertension. This was no emergency, she decided. She was wrong: The patient was, in fact, pregnant and in labor. By the time hospital staff realized that, it was too late. The baby was dead. And the patient, despite his own shock at being pregnant, was shattered.

Professors Running Scared of Students

To Dana Beyer, a trans activist in Maryland who is also a retired surgeon, such stories illustrate how vital it is that sex, not just gender identity — how someone perceives their gender — is taken into consideration in medicine. “The practice of medicine is based in scientific reality, which includes sex, but not gender,” Beyer says. “The more honest a patient is with their physician, the better the odds for a positive outcome.”

The denial of sex doesn’t help anyone, perhaps least of all transgender patients who require special treatment. But, Lauren says, instructors who discuss sex risk complaints from their students — which is why, she thinks, many don’t. “I think there’s a small percentage of instructors who are true believers. But most of them are probably just scared of their students,” she says.

And for good reason. Her medical school hosts an online forum in which students correct their instructors for using terms like “male” and “female” or “breastfeed” instead of “chestfeed.” Students can lodge their complaints in real time during lectures. After one class, Lauren says, she heard that a professor was so upset by students calling her out for using “male” and “female” that she started crying.

Then there are the petitions. At the beginning of the year, students circulated a number of petitions designed to, as Lauren puts it, “name and shame” instructors for “wrongspeak.”

One was delivered after a lecture on chromosomal disorders in which the professor used the pronouns “she” and “her” as well as the terms “father” and “son,” all of which, according to the students, are “cisnormative.” After the petition was delivered, the instructor emailed the class, noting that while she had consulted with a member of the school’s LGBTQ Committee prior to the lecture, she was sorry for using such “binary” language. Another petition was delivered after an instructor referred to “a man changing into a woman,” which, according to the students, incorrectly assumed that the trans woman wasn’t always a woman. But, as Lauren points out, “if trans women were born women, why would they need to transition?”

This phenomenon — of students policing teachers; of students being treated as the authorities over and above their teachers — has had consequences.

“Since the petitions were sent out, instructors have been far more proactive about ‘correcting’ their slides in advance or sending out emails to the school listserv if any upcoming material has ‘outdated’ terminology,” Lauren tells me. “At first, compliance is demanded from outside, and eventually the instructors become trained to police their own language proactively.”

In one point in the semester, a faculty member sent out a preemptive email warning students about forthcoming lectures containing language that doesn’t align with the school’s “approach to gender inclusivity and gender/sex antioppression.” That language included the term “premenopausal women.” In the future, the professor promised, this would be updated to “premenopausal people.”

Lauren also says young doctors are being taught to declare their pronouns upon meeting patients and ask for patients’ pronouns in return. This was echoed by a recent graduate of Mount Sinai Medical School in New York. “Everything was about pronouns,” the student said. The student objected to this, thinking most patients would be confused or offended by a doctor asking them what their pronouns were, but she never said so — at least not publicly. “It was impossible to push back without worrying about getting expelled,” she told me.

This hypersensitivity is undermining medical training. And many of these students are likely not even aware that their education is being informed by ideology.

“Take abdominal aortic aneurysms,” Lauren says. “These are four times as likely to occur in males than females, but this very significant difference wasn’t emphasized. I had to look it up, and I don’t have the time to look up the sex predominance for the hundreds of diseases I’m expected to know. I’m not even sure what I’m not being taught, and unless my classmates are as skeptical as I am, they probably aren’t aware either.”

Other conditions that present differently and at different rates in males and females include hernias, rheumatoid arthritis, lupus, multiple sclerosis, and asthma, among many others. Males and females also have different normal ranges for kidney function, which impacts drug dosage. They have different symptoms during heart attacks: males complain of chest pain, while women experience fatigue, dizziness, and indigestion. In other words: biological sex is a hugely important factor in knowing what ails patients and how to properly treat them.

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