is now clear that genes are vastly more influential than virtually any other force in shaping sex identity and gender identity—although in limited circumstances a few attributes of gender can be learned through cultural, social, and hormonal reprogramming. Since even hormones are ultimately “genetic”—i.e., the direct or indirect products of genes—then the capacity to reprogram gender using purely behavioral therapy and cultural reinforcement begins to tip into the realm of impossibility. Indeed, the growing consensus in medicine is that, aside from exceedingly rare exceptions, children should
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