The following Q&A with Ryan T. Anderson was conducted by Jonathan Last of The Weekly Standard. It has been republished here with permission.

Congratulations on regaining your title as History’s Greatest Monster! How does it feel? I’m kidding, but only sort of. One of the things I admire most about you is your ability to absorb the nastiest, most personal, least fair-minded abuse from critics and yet still engage with people in total good faith, all the time.

How do you do it? And I don’t mean “why do you do it”—everyone who does what we do for a living understands how valuable it is to reflect good faith in the face of bad faith. But it’s really hard. What’s your secret?

What’s my secret? Alcohol. As the great philosopher Homer J. Simpson once observed, alcohol is the cause of, and the solution to, all of life’s problems.

More seriously, while I do drink, that’s not the secret here. The real secret is that I have four very opinionated brothers, we grew up arguing, I attended a progressive-liberal-lefty Quaker school from first through 12th grade, and then went to Princeton for college. My entire life has been spent having people disagree with me, and, as you note, sometimes in less-than-charitable ways.

Oh, the stories I could tell you about the nonsense I put up with in high school. … When you don’t grow up in a bubble, it makes talking to people outside of various bubbles that much easier, and more natural. I know from firsthand experience that most people are just badly misinformed—they’re not evil, they just don’t know what they don’t know. And so you can’t take any of their vitriol all that personally, or that seriously. All you can do is try to speak the truth in tones and terms that they can understand.

Early inWhen Harry Became Sallyyou make a really, really important point—and it’s something I’ve always worried conservatives might miss: Many of the people who say they are transgender are suffering in very real, almost unimaginable ways. The suicide rates for people who are transgender, or suffer from gender dysphoria, are terrifying. If you’re an adult who’s so uncomfortable with your body that you’re willing to give up big chunks of your existing life and submit to painful and expensive surgeries, then what you’re feeling has to be real—it’s not some faddish lifestyle choice.

It’s incredibly easy to have compassion for people whose road is so difficult. And to want to do, as a society, what we can to make it easier.

But at the same time, the transgender political project—as something distinct from the needs of transgender people—is entirely different. It seems to be one of the most Jacobin, least compassionate political agendas of our time, happy to break whatever needs to be broken, with no regard for compromise, in order to assure perfect comfort for a very small number of people. Or at least that’s how it looks to me. What’s your appraisal of the transgender movement as an ideological force?

That’s exactly right. There is a huge difference between people who struggle with their gender identity and people who are LGBT activists. Most people who suffer from gender dysphoria are not activists, and many of them reject the activists’ claims. Many of them may be regarded as victims of the activists, as I document in the book.

Many of those who feel distress over their bodily sex know that they aren’t really the opposite sex, and do not wish to “transition.” They wish to receive help in coming to identify with and accept their bodily self. They don’t think their feelings of gender dysphoria define reality.

But trans activists do. And they tolerate no dissent. They’ve gone after “trans-friendly” doctors—who regularly support transition therapies for adults—for not being trans-friendly enough in encouraging children to transition.

I tell the story of one clinic in Canada in particular where this took place. They are suing Catholic hospitals for declining to perform sex-reassignment surgeries. They go after anyone who expresses any reservation at social transition for 5-year-olds, and puberty blockers for 9-year-olds. They accuse feminists—even lesbians—of being “transphobic” for not wanting people with penises in their locker rooms. And the activists are entirely out of step with ordinary people, including ordinary people with gender dysphoria and who identify as trans. I’ve met with people who identify as trans who hate the professional activists, who say that they don’t speak for them.

InWhen Harry Became Sallyyou talk about the contradictions inherent in the philosophy of the transgender movement. Can I put a quarter in the machine and have you dilate on them a bit here?

As I explain in the book, the thinking of transgender activists is inherently confused and filled with internal contradictions. Activists never acknowledge those contradictions, but opportunistically rely on whichever claim is useful at any given moment. Regardless of whether they identify as “cisgender” or “transgender,” the activists promote a highly subjective and incoherent worldview.

On the one hand, they claim that the real self is something other than the physical body, in a new form of Gnostic dualism, yet at the same time they embrace a materialist philosophy in which only the material world exists.

>>> Transgender Ideology Is Riddled With Contradictions. Here Are the Big Ones.

They say that gender is purely a social construct, while asserting that a person can be “trapped” in the wrong gender.

They say there are no meaningful differences between man and woman, yet they rely on rigid sex stereotypes to argue that “gender identity” is real while human embodiment is not.

They claim that truth is whatever a person says it is, yet they believe there’s a real self to be discovered inside that person.

They promote a radical expressive individualism in which people are free to do whatever they want and define the truth however they wish, yet they try ruthlessly to enforce acceptance of transgender ideology.

I could go on at length. In fact, I do. Here.

Same-sex marriage had a single goal, which, once achieved in one jurisdiction, virtually assured its creation everywhere—and the creation of same-sex marriage would then carry along a host of other political objectives (concerning religious freedom) in its wake.

Does the transgender project have a single paramount legal objective? Or is it comprised of a host of smaller legal challenges?

About a year ago, I did a debate at the law school at the University of Texas, Austin. My opponent, a lawyer and LGBT activist, opened his remarks with a simple statement of what guided his thinking on these policy questions: a transgender boy is a boy, and thus should be treated like all other boys; a transgender girl is a girl, and thus should be treated like all other girls.

This statement conveys a radical idea, and it reflects a shift of thinking among activists in recent years. No longer do they admit that a transgender boy is a biological girl who identifies as a boy, or that a transgender girl is a biological boy who identifies as a girl. Now they assert that people actually are the sex they claim to be.

This change in thinking is illustrated in the language favored by the Human Rights Campaign. When the organization published “Transgender Americans: A Handbook for Understanding” in 2005, it defined gender dysphoria as a person’s “discomfort from the strong internal sense that their true gender identity does not match their physical sex.” The handbook noted, without quibble, that gender dysphoria “remains listed as a mental disorder in the ‘Diagnostic and Statistical Manual of Mental Disorders.’

That was then. Now the Human Rights Campaign website gives this advice (with bolding and italics) to journalists for reporting about transgender people:

Refrain from contrasting trans men and women with ‘real’ or ‘biological’ men and women. Contrasting transgender people with ‘real’ or ‘biological’ men and women is a false comparison. They are real men and women, and doing so contributes to the inaccurate perception that transgender people are being deceptive when, in fact, they are being authentic and courageous.

This is a dramatic shift: from an emphasis on transgender identity being at odds with physical sex, to the idea of gender identity being essentially the determinant of sex; from acknowledging gender dysphoria as a mental disorder, to regarding transgender identities as just a variety of normal human development. These radical beliefs give rise to some equally radical demands.

In my book, I discuss them in three categories.

First, transgender ontology—the assertion that a “trans boy” is a boy, plain and simple, not a girl who identifies as a boy. You even get medical experts saying absurd things, like this: “It is counter to medical science to use chromosomes, hormones, internal reproductive organs, external genitalia, or secondary sex characteristics to override gender identity for purposes of classifying someone as male or female.” And here I thought those things were medical science. But the first set of demands are ontological in nature—to redefine reality.

Second, transgender medicine—the recommended four-step treatment process of social transition, puberty blockers, cross-sex hormones, and surgery. Activists want to see this “standard of care” mainstreamed and mandated. They want to have the government force all health care plans to pay for it, and to force all relevant physicians to perform it. As I mentioned, they’re suing Catholic hospitals for declining to do this.

Third is transgender policy—access to sex-specific facilities and programs, the lessons that children are taught about gender, the criminalization of “misgendering” someone, and the provision of desired medical services. And transgender policy follows from transgender ontology: People must be treated according to their self-declared “gender identity,” not their biological sex.

In all these areas, concerns about religious liberty, parental authority, and even privacy and public safety fall by the wayside—and that’s why you see so much pushback.

What are the legitimate concerns of the rest of society and where should we draw lines in order to protect the interests and rights of other people?

In “When Harry Became Sally,” I highlight five areas of concern for public policy in general:

1) Privacy interests when men who identify as women can enter female-only spaces.

2) Safety concerns when predators abuse gender-identity access policies.

3) Equality concerns when biological males can compete against females in sports and other arenas where sex differences are relevant.

4) Liberty interests when people are forced to speak or act in ways contrary to their best judgment and deeply held beliefs.

5) Ideology concerns about confusing messages that schoolchildren receive when they are taught that gender is fluid, falls along a spectrum, and is essentially detached from bodily sex.

Children are particularly vulnerable. We must do everything possible to protect them and provide a social environment where they can develop in a healthy way. We need medical professionals willing to help them mature in harmony with their bodies, rather than deploy experimental treatments to refashion their bodies. We need to respect the dignity of people who identify as transgender without trampling on the needs and interests of others. We need to acknowledge that taking our sexual embodiment seriously in public policy is not discriminatory. And we need a culture that cultivates a sound understanding of gender, one that allows each of us to flourish as a human being.

We should be tolerant—indeed, loving—toward those who struggle with their gender identity, but also be aware of the harm done to the common good, particularly to children, when transgender identity is normalized.

Transgender activists are not merely asking for tolerance or kindness—they are demanding affirmation, not just from adults but from children and adolescents who are already challenged by the normal process of sexual development. In a culture where transgender identities are not only affirmed but celebrated, everyone will be compelled to construct their own gender identity, unaided by a common understanding of sex differences and why they matter.

If you were counseling someone about how to talk about this subject with their friends, what’s the 30-second version of the case they should make for a sensible, compassionate approach?

Thirty seconds? Okay … The best biology, psychology, and philosophy all support an understanding of sex as a bodily reality, and of gender as a social manifestation of bodily sex. Biology isn’t bigotry. Every human society has been organized around a recognition that men and women are fundamentally different, and modern science shows that the differences begin with our DNA and development in the womb.

It is true that men and women differ among themselves, and that some people have difficulty identifying with their bodily sex. But this doesn’t mean that sex is either fluid or subjective, as transgender ideology maintains.

Many psychologists and psychiatrists think of gender dysphoria as similar to other dysphorias, or forms of discomfort with one’s body, such as anorexia. These feelings can lead to mistaken and harmful beliefs.

The most helpful therapies do not try to remake the body to conform with thoughts and feelings—which is impossible—but rather to help people find healthy ways to manage this tension and move toward accepting the reality of their bodily selves. This therapeutic approach rests on a sound understanding of physical and mental health, and of medicine as a practice aimed at restoring healthy functioning, not simply satisfying the desires of patients.

Is this a winnable fight? After the rout over same-sex marriage, every leftist cause carries with it a sense of inevitability. Is total victory inevitable for the forces of transgenderism?

Yes. Ordinary Americans are not on board with transgender ideology. Two friends of mine on the political left have given me cause to believe that transgender activists may have overplayed their hand and provoked a pushback.

One of these friends is a 20-something man who, with some bemusement, pointed me to the viral video du jour in which someone who describes herself as an “intersectional feminist,” a “queer girl,” etc., declared that having “genital preferences” is transphobic, and that “preferences for women with vaginas over women with penises might be partially informed by the influence of a cissexist society.” And no, this was not satire.

The video lecture went on: “If you’re a woman who only likes women, go ahead, identify as a lesbian. But some women have penises. And if the fact that some lesbians might be attracted to those women offends you, it’s because you don’t think trans women are real women.”

My friend objected to being judged transphobic and cissexist merely on the grounds that he dates biological women only. And when lesbians are accused of bigotry because they prefer women who don’t have male equipment, you have to wonder how long the “L” and the “T” can be held together in LGBT advocacy.

More significant doubts were expressed by a liberal friend who is the father of several children. He told me that he doesn’t care all that much about gay marriage—it doesn’t really affect him. (I happen to think he’s wrong about that.) But he cares very much about what affects his kids. He doesn’t want his daughter coming home from school to say that a boy who thinks he’s a girl is sharing a locker room with her. He doesn’t want his son to announce that he’s “gender fluid.” Average parents of various political stripes are not on board with “gender identity” access policies or school lessons about gender ideology.

But apart from these practical problems with trans ideology, there are three deeper reasons why the transgender moment will eventually pass, as I show at great length in the book.

First, they are always changing their creed and expanding their demands. Yesterday’s mandatory vocabulary will become tomorrow’s epithets. Yesterday’s enlightenment will be tomorrow’s benighted bigotry. Yesterday’s requirements of science and medicine and justice are tomorrow’s suicide-inducing oppression.

Second, even as their own position shifts, the activists are absolutely closed off to contrary evidence. They call for the censure of honest researchers. They refuse to give any consideration to competing interests of privacy or safety. They reject alternative therapies that may be favored by parents or doctors.

Third, because the transgender movement is so close-minded, it inclines toward coercion.

All of this suggests a posture of defensiveness—that activists know their claims can’t stand up to scrutiny. The movement has to keep patching and shoring up its own beliefs, policing the faithful, coercing the heretics, and punishing apostates, because as soon as its furious efforts flag for a moment or someone successfully stands up to it, the whole charade is exposed. That’s what happens when your dogmas are so contrary to obvious, basic, everyday truths.

All of which suggests that the transgender moment won’t be around forever. A transgender future isn’t the “right side of history.” And yet, the activists persist—and have convinced the most powerful sectors of our society to acquiesce to their demands. While the claims they make are manifestly false, it will take real work to prevent the spread of these harmful ideas.

The transgender moment may turn out to be fleeting, but that doesn’t mean we should expect it to fade away on its own. We need to insist on telling the truth, and on preventing lives from being irreparably damaged.