Last week the Supreme Court upheld a Tennessee law that denies minors access to gender-affirming medical care. The Court’s reasoning was asinine, decrepit, a national humiliation. But I’m not here to talk about that (next week’s 5-4 will cover it in depth). I’m here to talk about Clarence Thomas’s lengthy concurrence, joined by none of the other justices, in which he proffers his own defense of anti-trans legislation.

Clarence Thomas’s solo opinions are a useful window into the conservative soul. Thomas, more than his colleagues, is in tune with the conservative id. He operates off of the same base impulses and prejudices as Donald Trump, just filtered through a thin intellectual mesh. Thomas is also, to put it neatly, the best they can do. His writing is about as intelligent and cogent as reactionary legal thought gets. When you read his work, no matter how doltish it seems, it’s important to understand that it is the product of the movement’s sharpest mind.

Thomas’s concurrence starts off with some legal technicalities, but he quickly pivots into his main point: we shouldn’t be listening to experts. He is concerned because an array of large, prestigious medical associations weighed in on this case, and all of them (or at least, all of the respectable ones) said that gender affirming care for minors is both safe and effective.

Thomas writes:

There’s a lot here. But in short, the most prominent medical organizations in the world have one opinion on this issue, and Clarence Thomas has another. This is untenable and must be reconciled. And Thomas reconciles it the only way his brain will allow: the experts are wrong, and he is right.

Thomas’s argument breaks down into several broad points. First, he touts the wisdom of the legislators who passed the Tennessee law. This is standard Supreme Court stuff: whenever they’re upholding a law, they talk about how democracy is manifested through the noble legislator (when they’re striking a law down, they ignore that and talk about the value of individual liberty). More interesting are his claims that there is no medical consensus concerning treatments for gender dysphoria and that the purported experts in the field have been corrupted by ideology.

The basic argument here is that nearly every major medical organization in this country has either misevaluated the medical evidence or maliciously conspired to misrepresent the scientific consensus on trans health care. Moreover, Supreme Court Justice Clarence Thomas, handwaving away actual doctors and researchers as “so-called experts,” has figured out the truth.

Maybe the most illustrative element of Thomas’s opinion is that while he ignores the vast literature in support of gender-affirming care cited in the briefs of, e.g., the American Academy of Pediatrics, the sources he does cite are largely reporting from journalists with no relevant scientific background. 

Some of that reporting, like The New York Times’ coverage of anti-trans whistleblower Jamie Reed, has been called into question by subsequent stories indicating that Reed had made several key misrepresentations. Other sources are editorials rather than factual reporting. One, by mental slow-poke Pamela Paul, is about “rapid onset gender dysphoria,” the thesis that children are coming to the belief that they are transgender very suddenly during adolescence due to social influence from their peers. The thesis has been roundly critiqued as unscientific (Scientific American has a good round-up of the literature here), and Paul’s piece contains multiple misleading items (for instance, as Assigned Media pointed out, her claim that “detransition rates are higher than transgender advocacy groups suggest” cited a study that didn’t examine detransition at all).

Somewhere in his brain, Clarence Thomas understands that ignoring the research presented by dozens of medical organizations and instead favoring a handful of editorials written primarily by midwit journalists is not the best mode of analysis. He eases this dissonance by suggesting that those medical organizations have been co-opted by political forces and cannot be trusted.

Thomas’s primary example is WPATH, the World Professional Association for Transgender Health. WPATH has had some relatively minor controversies in recent years, which Thomas attempts to exploit to portray an entire field of expertise as suspect. But even those attempts are clumsy.

For example, Thomas, citing NYT reporting, states that “[u]nsealed documents reveal that a senior official in the Biden administration ‘pressed [WPATH] to remove age limits for adolescent surgeries from guidelines for care of transgender minors’ on the theory that ‘specific listings of ages, under 18, will result in devastating legislation for trans care.’” It’s true that Rachel Levine, Biden’s Assistant Secretary for Health and Human Services, asked that WPATH remove specific age listings from the care guidelines. What Thomas skirts around is that WPATH had proposed lowering age limits for care, and Levine cautioned against it, fearing backlash from Republicans. In other words, the guidelines are more conservative than they would have otherwise been, and to the extent that there was undue political influence involved in this case, it came from the right, not the left.

Just as telling as Thomas’s distrust of the experts are the people he actually does trust. Thomas cites this study to support his assertion that there is no medical consensus on the efficacy of puberty blockers. The authors of that study have extensive ties to the Society for Evidence-Based Gender Medicine (SEGM), an organization dedicated to opposing gender affirming care for minors that has been designated a hate group by the Southern Poverty Law Center. SEGM’s founder, William Malone, has said that “no child is born in the wrong body,” indicating that he does not believe that people can actually be transgender. He has advocated for making it a felony to provide gender affirming care to minors. These are the experts Thomas believes.

Thomas’s analysis has all the hallmarks of a conspiracy-addled brain. Conspiracists, generally unable to put forth a fulsome defense of their own position, become obsessed with the cover-up: the idea that their enemies secretly know that the conspiracy theory is correct, but are taking steps to hide it. This relieves them of the obligation to actually prove their theory - they instead pull cryptically on stray threads, trying to cast a shadow of doubt over what the experts claim. Once that shadow is cast, their imagination fills the darkness with whatever it wants.

Thomas, for example, despite spending several pages insisting that the WPATH transgender care guidelines are the product of political manipulation, never once challenges the guidelines’ substance. If the guidelines were, in fact, the output of a corrupted process, surely he could identify a portion of them that is medically unsound. But he cannot, or perhaps does not want to bother trying, because the point isn’t to provide a coherent theory as much as it is to undermine trust in the institutions that he deems his enemy. That allows him to imagine that the truth is whatever he wants it to be.

Thomas’s world is one where reality barely exists. Mountains of research can be dismissed in favor of a handful of op-eds. Dozens of prominent organizations can be disregarded as in thrall to liberal ideologies, while fringe right-wing groups are treated as unbiased purveyors of truth. The right had to build this world because the real one was untenable. In the real world, the empirical reality on hot-button issues favors the left. Trans health care is safe and effective, as are vaccines. Climate change is real. Immigration is a net positive across almost every metric.

Seeing all of this, the right has decided not to move left, but to reject expertise altogether. To them, empiricism itself is a captured institution. The result is a political movement where idiocy is not only tolerated but celebrated, the manifestation of steadfastness in the face of overreaching liberal institutions. College-aged interns who think they can run the federal government better than experienced bureaucrats. Roadkill-eating buffoons who think they understand vaccines better than scientists. Oafish Supreme Court Justices who think they know more about transgender health care than hundreds of experts combined.

You might have once thought that the right-wing base was distinguishable from the more reasoned, intellectual wing of the conservative movement; that somewhere behind the dimwitted rabble were serious people with serious ideas. Whether that was ever true, it’s decidedly not true now. Any vestigial intellectualism on the right has been leached away; it’s oafs and roadkill-eaters all the way down.