Not only is the U.S. failing to create enough new Americans through birth — it is also failing to turn immigrants into Americans in any meaningful sense.
“First world nations are dying,” Pat Buchanan warned in his 2002 book The Death of the West. “They face a mortal crisis, not because of something happening in the Third World, but because of what is not happening at home and in the homes of the First World.”
And what was not — and still is not — happening at home is childbearing. Buchanan was referring to fertility rates, which have been on the decline for decades.
Data released on Thursday by the Centers for Disease Control and Prevention (CDC) shows U.S. birth rates are dropping to levels of civilizational suicide, with women having on average 1.6 children. According to the CDC data, birth rates dropped for women aged 15-34 between 2023 and 2024 while rising for women aged 40-44. The general fertility rate (GFR), which is the number of births per 1,000 females ages 15-44, “is down 22% from 2007 to 2024.” While fertility rates are down, the number of births increased by roughly 1 percent between 2023 and 2024, according to the data.
Women are delaying having children or completely casting it aside — thanks in part to the rise of the obnoxious hyper-independent girl boss mentality that has asserted that marriage and motherhood are shackles, along with the “loss of religiosity” and “availability of birth control” and abortion, as pointed out in these pages by David Harsanyi.
The result? The country is dying.
As Buchanan warned, a nation that will not reproduce will not survive. A shrinking native population leads to one inevitable outcome: mass immigration.
As noted by The Heritage Foundation’s Jonathan Abbamonte, “without a substantial increase in fertility, the United States will continue to be increasingly dependent on immigration to slow down population ageing and prevent population contraction.”
One of the most obvious results of a shrinking population is a shrinking workforce. But a workforce is rather interchangeable. A country can always import labor — the United States can import labor for the foreseeable future if there is a shortage of workers. But what a country cannot import is a culture, a heritage, a set of particular values that will help the republic endure.
America simply cannot outsource her future to people from other places. And it’s not about “xenophobia” or whatever other “phobia” the left will throw at Americans. A country — any country — that replaces its population with people from somewhere else because its own people will not reproduce becomes something else entirely. If we don’t make more Americans, we won’t have any more left. And without Americans, there will be no America.
Not only is the U.S. failing to create enough new Americans through birth — it is also failing to turn immigrants into Americans in any meaningful sense — making the prospect of boosting the dying population with foreigners even more problematic. Of course, this hasn’t always been the case. In the 19th and 20th centuries, the U.S. successfully assimilated millions of immigrants — Germans, Italians, Poles, Irish, and so on and so forth — because they shared a foundation of similar cultural and social norms, values, and religion. They often became Americans within a single generation.
But since the 1965 Immigration and Nationality Act, that assimilation process has broken down. America has seen a wave of mass migration from nations that are dissimilar to it. Different languages, cultures, religions, and political philosophies are all things that act as barriers to assimilation. And the one thing that could ease the assimilation process has been undermined by the left — that thing being a shared national identity. The left abhors American exceptionalism. They demonize it, teaching children and young adults that America is an evil place that must atone for her sins. So how are we supposed to assimilate foreigners into America’s culture and way of life when we ourselves have vilified and rejected our own heritage?
American birth rates have now dropped to levels of civilizational suicide. And in the vacuum left by a people that won’t reproduce, another people will — but they won’t be American.
Brianna Lyman is an elections correspondent at The Federalist. Brianna graduated from Fordham University with a degree in International Political Economy. Her work has been featured on Newsmax, Fox News, Fox Business and RealClearPolitics. Follow Brianna on X: @briannalyman2
Last week in Denver, several hundred people gathered in person for the Genspect conference, “The Bigger Picture,” while many more from all over the world joined online. Genspect’s founder, Stella O’Malley, has the intentional strategy of hosting their annual conference at the same time and in the same location as the annual World Professional Association for Transgender Health (WPATH) meeting.
Last year they gathered in Killarney, Ireland, when WPATH met there, and next year they will host their gathering in Lisbon, Portugal, piggybacking off of the WPATH dates and location. It’s an interesting strategy offering WPATH attendees to come to Genspect’s sessions for free whereby they can engage with a different perspective, as well as putting WPATH on notice that there is a growing movement of those who want to offer a “healthy approach to sex and gender.”
I was unable to attend their gathering last year in Ireland, but when O’Malley invited me to speak at the Denver conference, I was happy to accept. The speaker’s list was a who’s who of those fighting gender ideology, some for many years.
On the Front Lines of the Gender Wars
Michael Shellenberger opened the conference with a bold claim that time is up for WPATH and that soon he would release his “WPATH files” on his Substack, where he will show the receipts he has on the pseudoscientific standards of care and practices of WPATH. Amid robust applauses, attendees were encouraged to post on X using #TimesUpWPATH. A lifelong member of the Democrat Party, he lamented how far the left has fallen from the principles that drew him to that party.
Highlights for me were hearing from the brilliant Leor Sapir on “Institutional Capture (How gender ideology has been embedded within America).” Sapir chronicled Obama’s 2010 anti-bullying initiative, which was at first sex-based directed, and then expanded in 2011 to include gender language in the antibullying initiative.
Following this was the 2015 letter from James Ferg Cadima in the Office of Civil Rights, stating, “The Department’s Title IX regulations permit schools to provide sex-segregated restrooms, locker rooms, shower facilities, housing, athletic teams, and single-sex classes under certain circumstances. When a school elects to separate or treat students differently on the basis of sex in those situations, a school generally must treat transgender students consistent with their gender identity.”
Wonder how America got to this place? Perhaps a well-intentioned initiative to combat bullying quickly led us down the path where boys can have access to spaces that were once protected for girls.
Evolutionary biologist Colin Wright and scientist Heather Heying did an excellent job, patiently and thoroughly stating the obvious, that there remain only two sexes no matter what others assert. They marveled at the fact that even once-trusted scientific journals are now claiming that “The idea of two sexes is overly simplistic.”
Two mothers, January Littlejohn and Erin Friday, gave impassioned speeches about their daughters who believed the lie that they were born in the wrong body. Littlejohn spoke about her daughter’s middle school working behind their back to encourage this idea and talked about her decision to bring forth a lawsuit, restoring rights and protections to parents over their own children.
Friday, an attorney by training who works with Our Duty, had many in tears using Hans Christian Anderson’s story of “The Snow Queen” to parallel her own efforts to save her daughter from the evils of gender ideology. She is a force in the state of California, fighting laws passed by Gov. Gavin Newsom while trying to raise funds to get initiatives on the ballot to put before voters which will protect children and parental rights. She appealed to the audience that if the transing of children can be stopped in California this will have an enormous positive effect across the whole country.
Stories of Destransitioning and Whistleblowers
Any conference like the one hosted by Genspect naturally needs to include the voices of those most harmed by “gender affirmation therapy,” those who transitioned and have now detransitioned once they realized their decision to transition didn’t fix any of their mental health issues, and as is often the case, made things worse. Chloe Cole and Prisha Mosley both spoke about their deeply personal experiences. Many other detransitioners attended the conference as well. It was wonderful to see how their tragic stories have brought them together in the spirit of camaraderie.
And who doesn’t love a good whistleblower story like Jamie Reed? Reed blew up the internet back in February with her expose, “I thought I was Saving Trans Kids. Now I’m Blowing the Whistle.”
Since 2018, Reed served as a case manager at Washington University, in their Transgender Center at St. Louis Children’s Hospital, until she came to the realization that she could no longer condone the treatment children were receiving. Her remarks at Genspect were a rallying cry for the political left to wake up and stop harming children. As a lifelong leftist, she implored the audience not to give up on the left, but to help them return to principles.
The title of my own talk — “Transgender Assisted Reproduction: where is this going?” — was a convergence on my years of work in assisted reproductive technology and how this technology will most likely be needed by trans-identifying people, especially children who are fast-tracked to puberty blockers, cross-sex hormones, and surgeries.
When I first found out that children were being offered fertility preservation procedures, knowing
that “gender affirmation care” harms natural and normal fertility, I began speaking up and producing documentary films about the lack of medical ethics and evidence-based medicine supporting these practices. Pre-puberty, children are offered to cryopreserve their ovarian or testicular tissue because their gametes, (ova and sperm) are not yet mature. Post-puberty, the child will have mature ova and sperm, so they are offered to freeze and bank their gametes.
The data is clear. Most assisted reproductive technology cycles fail. Data is coming out about the harms and risks to children being created by these technologies. The maxim, “First, Do No Harm” is being ignored in offering hope of future children, when in fact this is considered an experimental procedure with no data on this population. From the audience’s reactions and comments, it was clear that this is a whole new level of doubling down on harming children to advance an ideology that ignores biological reality, evidence-based medicine, and medical ethics.
Times up, WPATH.
Jennifer Lahl, MA, BSN, RN, is a filmmaker and founder of The Center for Bioethics and Culture Network. She is on X @JenniferLahl
After being swarmed by health providers who enabled her to medically transition as a minor, Prisha Mosley now says she’s been abandoned by the medical community as she attempts to navigate a complicated and painful detransition.
“I was under the impression that my doctors, who were transitioning me, loved me. They said they didn’t want me to die, they were saving my life, they were worried about me, and they wanted me to be healthy and happy,” Prisha told me. “Clearly, they don’t love me. As soon as it’s not profitable, they don’t want to help.”
Prisha has a slew of medical complications dating back to the more than five years she spent on testosterone and a double mastectomy that a plastic surgeon performed shortly after she turned 18. Many of those complications surround her endocrine system, which encompasses the hormones that regulate nearly every process in the body, from metabolism to growth and development, emotions, mood, sexual function, and sleep.
“I was hoping that if I could get my endocrine system working, I could be on less psychiatric medicine because low testosterone and estrogen will cause depression and anxiety, both of which I’m medicated for and don’t really like being medicated for,” she said.
Prisha also hopes that with estrogen supplements, she’ll experience some muscle and fat redistribution. After years of testosterone broadened her neck and shoulders, she now carries more weight in her upper body, which causes her chronic pain. Her throat is sore, she can no longer sing or raise her voice, and she suffers hair loss, as well as hair growth on her body, which she has to treat with costly laser hair removal sessions.
Another side-effect Prisha is seeking medical attention for is severe sexual dysfunction, which is so bad, she says she can no longer use tampons.
“I used to be able to, and now I can’t,” she said. “And that sucks. There’s pain, there’s irregular periods, and atrophy.”
No Medical Professionals Will Help
Hormonal care to fix her endocrine system, she hopes, could help her become more feminine — and perhaps fertile again. But she said every primary care physician, endocrinologist, obstetrician, and gynecologist she’s approached on her insurance list has turned her away or said they can’t help.
“I could call and be rejected every single day,” according to Prisha.
Professional organizations that represent many of these providers claim to offer open, inclusive, supportive care for “transgender” and “gender diverse” individuals. That offering, it appears, doesn’t apply to individuals seeking to detransition.
Prisha isn’t the only detransitioner who feels abandoned by the medical institutions that pushed her into wrong-sex hormones and surgery. Over the past year, Independent Women’s Forum has documented multiple stories of detransitioners who also report being abandoned by medical and mental health professionals after deciding to detransition.
“I reached out to every physician, every therapist who is involved with this, and I haven’t really gotten any help at all,” said Chloe Cole, an 18-year-old who was fast-tracked down a medical transition as a child by a team of eager doctors. Left to navigate the detransition process on her own, Chloe stopped taking testosterone “cold turkey,” and is still struggling with urinary and other complications that doctors have yet to help fix.
Cat Cattinson, a woman who medically transitioned to a wrong-sex identity in her 20s before realizing it was a major mistake, said access to medical care from providers who are knowledgeable is one of the major barriers detransitioners face:
Because of the experimental nature of gender medicine, doctors know very little about the long-term effects of medical transition and even less about the health-care needs of those who detransition. Surgeries, obviously, are irreversible, but hormonal interventions can also have lasting effects requiring treatment to mitigate. Testosterone caused irreversible changes to my vocal cords, resulting in daily discomfort and pain, but most ENTs [ear, nose, and throat doctors] and other voice ‘professionals’ are not informed about how testosterone affects a female voice or how to help someone in my situation.
Prisha doesn’t know why she’s been turned away from so many doctors and medical providers — whether it’s about money, politics, or a lack of knowledge to help. If it’s the latter, one might ask why medical professionals are allowed to put individuals, including minors, on drugs and “treatments” that they’re unable to later undo or address, should that patient change his or her mind.
Whatever the reason, the inability to access medical attention is having a profound effect on Prisha, beyond her physical health.
Prisha’s Mental Health Struggles
Prisha, who attends school in Big Rapids, Michigan, has a long and complicated history with borderline personality disorder, anxiety, depression, and other mental illnesses. Now 24, Prisha says she used transitioning as a cover for her deeper-rooted mental health issues.
Since detransitioning, Prisha’s been in dialectical behavior therapy to manage her borderline personality disorder — therapy she credits with saving her life.
“When I treated that, all of the symptoms started getting better,” she said. “Nothing that I did to transition treated those things that were causing me mental suffering.”
But now as a detransitioner, even her therapy treatment is in disarray. A few months back, Prisha lost her health insurance because she couldn’t afford it. Under her new insurance, instead of being charged $10 per therapy appointment, she is being charged $96, an increase she wasn’t aware of for five months. Prisha now owes nearly $3,000 to her therapist, a service she depends on.
Upon going public with her story, Prisha started a campaign to raise money for breast reconstructive surgery, something she wishes to pursue to resolve the “phantom breast syndrome” she often experiences, and to appear more feminine.
But because the surgery is not deemed “a medical necessity,” Prisha would have to pay for it fully out-of-pocket. She would also need at least two surgeries to stretch her skin and reconstruct her breasts, estimated at more than $11,000 each. During this process, Prisha says she was told she would risk losing her nipples, which her plastic surgeon removed and reattached in more masculine positions.
The dream of breast reconstructive surgery and the $4,000 she’s raised for it thus far were put on hold, as Prisha is left using every penny she has to pay for her therapy and basic health insurance coverage.
“I feel like it’s like a bottomless pit — the medical needs, and I need the therapy because I can barely do this,” she said. “And I’m absolutely not going to, once again, medicalize my body without taking care of my mind.”
Now in debt and being rejected by one doctor after another, Prisha is at a loss for what to do. In an act of desperation, she turned to Plume, a company that has raised millions of dollars to connect patients with physicians who can prescribe them “gender-affirming hormone replacement therapy” online, including a “one-time medical letter of support for surgery with a one week turnaround time” for a fee of $150. But this time, instead of affirming her identity as the opposite sex, Prisha sought the help of Plume to get blood tests and hormone treatments to affirm her true sex: a woman.
Screenshot of Plume website.
After paying $99 and scheduling an appointment with a provider, Prisha said she was “ghosted” 40 minutes before the appointment. Plume hasn’t responded to Prisha’s requests for an explanation or even a refund. She suspects the provider canceled last minute because Prisha disclosed that she was “detrans” in initial paperwork she completed just minutes before the canceled appointment. After she submitted her intake forms, “All contact dropped off,” Prisha said. She then took to YouTube to share her devastation.
“I don’t know what to do, I don’t know who to go to because no one will help,” Prisha said through tears. “I was really hoping that they would care about me and help me. I just want to feel better. I just want to be better. I don’t want my body to be like this anymore. I’m in pain. … I can’t take it anymore.”
Independent Women’s Forum reached out to Plume to ask whether the company offers its services to detransitioners. Plume did not respond to our request.
The situation led Prisha to consider self-medicating. But due to her family history with mental illness and addiction, she’s doing everything in her power to resist that path.
“I’m feeling pushed to go that route because no doctor will help me,” she said. “It is deeply triggering my [borderline personality disorder] abandonment and rejection issues. It’s really easy to slip into the mindset that everyone hates me, I’m a medical monster, I’m bad and evil, and I deserve this.”
“It’s just being abandoned,” Prisha added. “I feel abandoned.”
Kelsey Bolar is a contributor to The Federalist and a senior policy analyst at Independent Women’s Forum. She is also the Thursday editor of BRIGHT, a weekly newsletter for women, and the 2017 Tony Blankley Chair at The Steamboat Institute. She lives in Washington, DC, with her husband, daughter, and Australian Shepherd, Utah.
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American Family Association (AFA), a non-profit 501(c)(3) organization, was founded in 1977 by Donald E. Wildmon, who was the pastor of First United Methodist Church in Southaven, Mississippi, at the time. Since 1977, AFA has been on the frontlines of Ame
American Family Association
American Family Association (AFA), a non-profit 501(c)(3) organization, was founded in 1977 by Donald E. Wildmon, who was the pastor of First United Methodist Church in Southaven, Mississippi, at the time. Since 1977, AFA has been on the frontlines of Ame
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