By Patrick D Hahn, Lies are Unbecoming
When I interviewed Patrick Hahn in April of 2024, I already knew the shape of his work. Across four books in four years — on psychiatric genetics, antidepressants, the ADHD industry, and the COVID shots — he had built a method I had come to trust: go back to the primary literature, follow the money, and refuse to mistake institutional consensus for evidence. He is a biologist and a university teacher by training, not a physician, and he has always been candid that his outsider’s vantage is the point. He reads the studies the experts cite and notices what those studies actually say, as opposed to what we are told they say. Irreversible is the latest and boldest application of that method, and it is, I think, his most important book.
Hahn announces his hand on the first page: this is “a work of advocacy,” and he refuses to pretend otherwise, arguing that what the subject needs is not a balanced book but a balanced debate — one he says has been ruthlessly foreclosed. From there he does something few of the subject’s commentators have bothered to do: he goes back to the beginning. The book traces medicalized sex reassignment from Magnus Hirschfeld’s Institute for Sex Research in 1920s Berlin, where the first such surgeries were performed, through Harry Benjamin, the rise and fall of the Johns Hopkins gender clinic, John Money and the David Reimer catastrophe, and on to the modern battles over pediatric care, the collapse of London’s Tavistock service, and the Cass Review. It is genuine history, carefully sourced, and it reframes the present by showing how recent and how contingent the whole enterprise really is.
The book’s argumentative spine is Hahn’s contention that what is now marketed as “gender-affirming care” is not medicine in any ordinary sense but a commercial phenomenon he calls “Transgender Inc.,” built on the model of Big Tobacco and Big Pharma. This is the same nexus of incentives he anatomized in his earlier books — drug-company-funded key opinion leaders, captured regulators, patient-advocacy groups functioning as tax-deductible advertising, and a press dependent on pharmaceutical money. In Hahn’s telling, the field’s most drastic interventions have been deployed on the strength of strikingly weak evidence, and he marshals the field’s own admissions to make the case: a major UK research body conceding it does not know whether puberty blockers are safe or helpful, even as thousands of children received them. When the people selling an intervention admit they don’t know if it works, Hahn argues, the burden of proof has not been met — and his decades of reading industry-funded trials make him an unusually sharp guide to how that burden gets evaded.
His sharpest language — describing the phenomenon as a “mania” and a “social contagion,” the desire to change sex as a “delusion,” the interventions on minors as “mass castration” — will be the most contested thing about the book, and Hahn knows it. He chooses these words deliberately, and a reader can disagree with the framing while still being unable to dismiss the documentary substance underneath it. What gives the book its force is that Hahn does not rest on rhetoric. He lets the primary sources carry the weight: the older case reports in which clinicians describe distressed young people whose certainty about surgery dissolved through ordinary psychotherapy, and whose lives went on. Those cases sit uncomfortably against the modern insistence that such feelings are fixed and that medical transition is the only humane response.
The most affecting chapters are the testimonies. Hahn gives space to detransitioners and to surgical patients like Ritchie Herron and Scott Newgent, and he has the restraint to let them speak for themselves. These are not polemics; they are people describing, in their own words, what was done to them and what it cost. Herron’s plea — that he wants to tell everyone “what irreversible really means, and what that reality looks like for us” — gives the book its title and its conscience. This is the same instinct that ran through Hahn’s earlier work: the conviction, as he put it to me, that the best experts are the people who have been harmed and gaslighted by the very system that claimed to be helping them. Whatever one’s starting assumptions, these accounts are hard to read and harder to forget.
Hahn writes that he expects to pay a price for this book — that after publication he may be unable to earn a living in the country he spent his life helping to build, and that he would rather start over abroad than stay silent. He closes not with himself, though, but with a question aimed at the reader. There will come a day, he writes, when these procedures are remembered alongside lobotomy and foot-binding, and your grandchildren will read about them and ask: Did they really do these things to people? To children? And you will have to answer — either that some of us refused to look away, or that “the science changed.” That is the choice the book leaves you holding, and it is not a comfortable one. If it unsettles you, that is precisely the point. Patrick Hahn has risked a great deal to put this argument in front of us; the least we can do is read it, weigh it honestly, and support the work. Irreversible is available here: [link to buy] — buy a copy, and consider following his ongoing work at patrickhahn.net.
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