When 'Sissy Boys' Become Medical Patients

Growing up, when Ben Appel answered the phone, callers would mistake him for his mother Nancy. "No, it's her son, Ben," he'd correct them, and they'd apologize as if there were "no greater tragedy for a boy than being mistaken for a girl." But in his fundamentalist Christian community called the Lamb of God, his flamboyance wasn't a problem—what mattered was having a heart "on fire for the Lord."

Today, Appel's childhood story cuts to the heart of one of the most contentious debates in modern medicine: Are effeminate boys really girls trapped in the wrong bodies, or are we medicalizing natural variations of masculinity?

The Vanishing of Gender-Nonconforming Boys

Appel's world shifted dramatically when he entered public middle school in 1995. His overly polite request for chalk from a neighboring classroom—"Can I interrupt you for a moment?"—drew snickers and whispers: "Is that a boy or a girl?" Soon came the taunts: "Ben-gay" and "Ben is a fag" scribbled in library books.

What's striking about Appel's account isn't just the bullying, but the medical landscape that didn't exist then. Had someone suggested he might be "born in the wrong body" with a "medical solution," he wonders how he would have responded. "You mean this isn't a spiritual defect? I'm not evil? It's just a medical condition?"

This hypothetical scenario has become reality for many children today. According to a 2019 report in The Times of London, staffers at Britain's foremost gender-identity clinic joked darkly that "there would be no gay people left" as a result of their work. The implication: children who might have grown up to be gay men are instead being treated for gender dysphoria.

The Medical Rush to Treatment

The American Society of Plastic Surgeons stated last month that there's "no validated way to assess whether a child's gender distress will persist over time or disappear without medical intervention." Yet many doctors and hospitals have provided puberty blockers and hormone treatments to minors after "only the briefest evaluation."

Research from Dutch clinicians who administered puberty suppression to 70 adolescents from 2000 to 2008 reveals a telling pattern: the overwhelming majority were attracted exclusively to people of their biological sex. This aligns with broader data showing that most prepubescent children experiencing gender distress ultimately don't pursue gender transition and develop same-sex attraction.

The Cost of Questioning

Appel's decision to voice concerns about pediatric gender medicine came with steep social costs. Someone added him to an online blacklist titled "Ben Appel vs. Transgender People," including personal details about his family members. A former colleague contacted his employer's CEO to report his journalistic work. At his best friend's baby shower, a decades-long friend who had attended his wedding and father's funeral told others he was "hurting trans kids."

These experiences illuminate how political polarization has made nuanced discussion nearly impossible. As Appel notes, "The more Trump and his followers opposed something, the more we were supposed to support it." This binary thinking leaves little room for the complex realities of childhood development and identity.

Beyond Medical Solutions

Appel's prescription is refreshingly straightforward: tell gender-nonconforming children the truth. "The difference he feels is real. He is unlike most of his peers. Throughout history, there has always been a minority of people who share the interests of and behave more like the opposite sex." Let him wear the dress and carry the doll if he pleases—"boys can do those things too."

This approach acknowledges difference without pathologizing it. It offers acceptance without medical intervention. Most importantly, it recognizes that society's discomfort with gender nonconformity shouldn't become the child's medical problem.