A Wall Street Journal opinion columnist compared modern so-called “gender-affirming” medical interventions to the once-widespread practice of lobotomy, arguing that clinicians who subject minors to the sexual procedures are repeating historical medical failures.
In a Feb. 11 column for the Journal’s Free Expression newsletter, author Louise Perry wrote that “the diagnosis of gender dysphoria bewitched the medical community like the brutal brain operation once did.” She drew parallels between contemporary “transgender” medical intervention and the mid-20th-century brain surgery that was once hailed as a breakthrough treatment for mental illness before later being universally condemned as harmful and unethical.
Perry’s essay centers on the case of Fox Varian, a 22-year-old woman who detransitioned after undergoing a double mastectomy at age 16. A jury in White Plains, New York, recently awarded Varian $2 million in a medical malpractice case in which she alleged that a psychologist and plastic surgeon failed to obtain adequate informed consent before the procedure — meaning they did not fully explain the risks, potential complications, long-term consequences, and alternatives before she agreed to undergo the mastectomy.
According to Perry’s account of the trial, Varian’s mother testified that psychologist Kenneth Einhorn repeatedly assured her the surgery would improve her daughter’s well-being and warned she might otherwise commit suicide.
Perry argued that some clinicians involved in so-called “gender-affirming care” should face professional consequences.
“There are many clinicians working in the field of so-called ‘gender-affirming care’ who deserve to lose their licenses, plus a few who deserve to go to prison,” she wrote.
“Try and forget, for the moment, the social whirlwind that has surrounded this area of medicine,” Perry wrote, arguing that “the celebrity endorsements, the glossy TV portrayals, the craven journalists” have “served to distract us from what has really been going on.”
Perry urged readers to think about “what is actually involved in trying to make a person superficially look like a member of the opposite sex,” such as “the off-label use of powerful drugs” as well as “the removal of perfectly healthy breasts and genitals.” She also referenced procedures such as colovaginoplasty and phalloplasty, which are attempts “to create new organs out of the wrong tissue” that can lead to disastrous complications.
She cited a 2024 British review led by pediatrician Dr. Hilary Cass, which concluded that the evidence base for youth gender treatments is “remarkably weak.” Perry wrote that “some parts of the medical community are now turning against the use of such interventions for children” and suggested that scrutiny may expand to adult treatments as well.
Drawing a historical analogy, Perry compared the rise of gender medicine to the popularity of lobotomies in the U.S., which were performed approximately 50,000 times, mostly between 1949 and 1952. She highlighted psychiatrist Walter Freeman, who promoted the procedure despite ethical objections.
Perry argued that Americans should resist what she called “chronological snobbery” — the tendency to view past medical practices as uniquely barbaric while assuming contemporary medicine is immune from similar error.
Lobotomy, she noted, once carried institutional prestige and apparent scientific justification. Doctors such as Freeman, she wrote, pursued the procedure with “very little restriction,” dismissing ethical objections as “a waste of time” because they believed they were relieving profound psychiatric suffering.
“Freeman and his allies really did think they were doing good,” Perry wrote, but “some of the outcomes were terrible.” For example, Howard Dully, who underwent a lobotomy at age 12, experienced lasting cognitive and emotional effects.
“If our forebears were transfixed by Freeman’s status as an eminent WASP [White Anglo-Saxon Protestant],” Perry wrote, “we have been bewitched by the social-justice messaging around gender-affirming care.”
As with lobotomy, she wrote, many practitioners may sincerely believe they are helping patients, but “it’s remarkably easy for doctors to double down on a misguided protocol,” particularly when they lose sight of what she described as medicine’s “foundational principle”: “Do no harm.”
She concluded that a growing movement of detransitioners is seeking legal redress and predicted that malpractice lawsuits will increase. While financial compensation may be possible, she wrote, “the physical harm done to them can’t be reversed.”