Philip McGarry: Words matter when it comes to the transgender debate

‘Transphobia’ is essentially a made up word, and replicates the structure of another neologism, ‘Islamophobia’. It is now very widely used, primarily as a way of dismissing the target as a bigot, and typically renders any reasonable discussion almost impossible.

As a psychiatrist I have a fundamental objection to pseudo psychological terminology being brought into the most divisive areas of public discourse.

A true phobia has three key elements.

Firstly there must be intense, irrational anxiety out of proportion to the situation, secondly, this extreme level of fear must lead to marked avoidance behaviour, and thirdly, it must have a significant negative impact upon the person’s quality of life.

It is therefore perfectly obvious that it is totally inappropriate to add the suffix ‘phobia’ to create a new highly charged word, outside of the arena of mental illness.

It is alarming how these words have so quickly come to be adopted not only by activists, but also by mainstream politicians and governments.

Orwell pointed out 80 years ago: “The term fascism now has no meaning except to signify something not desirable”.

And today ‘fascism’ is still often casually used with no respect for what it actually means (ultra nationalism, with the essential element of the use of intimidation and violence by a private army to control its own citizens).

Orwell also wrote: ‘If thought corrupts language, language can also corrupt thought”. In any healthy democracy, we (should) resolve differences and make progress through rational debate. And the fundamental tool of debate is vocabulary.

It is therefore imperative that we use words and language which convey clear and precise meaning, to enable us to discuss constructively the complex and controversial issues of the day.

If however aggressive and technically inaccurate words such as ‘transphobic’, ‘Islamophobic’ and ‘fascist’ are introduced into the conversation, this not only prevents meaningful dialogue, but dramatically polarises the debate and leads to ill-feeling (and sometimes worse).

Another dangerous effect of the abuse of language is that people avoid talking about certain topics, for fear of being seen as offending against the orthodoxy of the day and therefore accused of being ‘phobic’.

Dr Cass made what was a truly astonishing comment : "Professionals are increasingly scared to openly discuss their views on the treatment of children with gender identity problems”.

Doctors have a primary ethical obligation to be always questioning the evidence, and looking at every possible way of improving the well being of their patients. As in any intellectual endeavour, no debate should be a priori ‘off limits’.

The key professional organisations will have to investigate how we got into this mess whereby experienced clinicians and managers were unable to call out and prevent highly dubious practices.

Discrimination against trans people is disgraceful and must always be challenged.

In the late 1980’s I worked with trans patients as a senior registrar at the Psychosexual Clinic in Belfast. They were invariably complicated people with difficult life experiences, but were very pleasant individuals to work with.

However it has been counter productive for trans people themselves that transactivism has become so belligerent that it has alienated the public (and professionals who increasingly no longer want to work in this area ).

Similarly, prejudice against Muslim people is outrageous, and must always be challenged.

However the blanket use of ‘Islamophobia’ is used all too often as a weapon to silence those who raise legitimate questions about Islamism, and indeed standard Islamic practices and beliefs, thus closing down what should be a constructive discussion.

In western democracies people have (rightly) long challenged and indeed mocked Christianity, and no religion should be exempt.

An example of shutting down debate is the absurd criticism of the well know Iranian Human Rights campaigner Masih Alinejad for being supposedly ‘Islamophobic’.

In our own society we have specific terms which are misleading and offensive.

The widespread use of the ugly phrase ‘punishment shooting’ in essence sanitises - uniquely in any democracy- the abuse of children and young adults.

Words matter; they are the basis of communication, but they can be used to intimidate people and shut down debate. Once accepted into routine public discourse they can, as in the Tavistock Clinic, have a chilling effect.

Be wary of cliches, terms that seem exaggerated, and above all, new words with ‘phobia’ stuck on at the end!

Instead, use, and expect others to use, words with clear and specific meanings.

Dr Philip McGarry FRCPsych is a consultant psychiatrist and former Alliance Party chair.