The journal Nature has published peer-reviewed research in all fields of science since 1869. It’s one of the most respected international journals of science.
From the editorial:
The proposal — on which HHS officials have refused to comment — is a terrible idea that should be killed off. It has no foundation in science and would undo decades of progress on understanding sex — a classification based on internal and external bodily characteristics — and gender, a social construct related to biological differences but also rooted in culture, societal norms and individual behaviour. Worse, it would undermine efforts to reduce discrimination against transgender people and those who do not fall into the binary categories of male or female.
Furthermore, biology is not as straightforward as the proposal suggests. By some estimates, as many as one in 100 people have differences or disorders of sex development, such as hormonal conditions, genetic changes or anatomical ambiguities, some of which mean that their genitalia cannot clearly be classified as male or female. For most of the twentieth century, doctors would often surgically alter an infant’s ambiguous genitals to match whichever sex was easier, and expect the child to adapt. Frequently, they were wrong. A 2004 study tracked 14 genetically male children given female genitalia; 8 ended up identifying as male, and the surgical intervention caused them great distress (W. G. Reiner and J. P. Gearhart N. Engl. J. Med.350, 333–341; 2004).
Even more scientifically complex is a mismatch between gender and the sex on a person’s birth certificate. Some evidence suggests that transgender identity has genetic or hormonal roots, but its exact biological correlates are unclear. Whatever the cause, organizations such as the American Academy of Pediatrics advise physicians to treat people according to their preferred gender, regardless of appearance or genetics.
The research and medical community now sees sex as more complex than male and female, and gender as a spectrum that includes transgender people and those who identify as neither male nor female. The US administration’s proposal would ignore that expert consensus.
In North Carolina similarly narrow and unscientific views of gender have cost transgender state employees and dependents their health coverage, putting the state on the business end of lawsuits other states have already lost and at odds with the state’s top medical experts on the issue.