For such a vexing topic as gender identity, this dissertation asks a rather straightforward question: If gender identity is—as Judith Butler has asserted—socially constructed and discursively mediated, then why does transgender hormone therapy (THT) work? This is the question concerning endocrinology that I ask Butler, and their answer is, if requiring of delicate assessment and interpretation, clear: it doesn't. Butler's work reveals an admonishing view that the efficacity of THT is due to placebo effect, in turn brought on by the bewitchment of the trans* who seeks medical transition. In a logic similar to sin and salvation, if only the trans* had not believed in gender dysphoria, then there would be no (putative) efficacity to THT whatsoever. With our answer, we begin a perilous adventure of discovering just why such a preeminent gender theorist (and trans* themselves) with no experience of gender dysphoria, and no desire to medically transition, would say this. We examine Butler's gender theory, their concept of desire, their views on the self, on transsexuality, their rarely discussed philosophies of science and nature, and their dearth of citations of transsexual voices. Due to this lack, I lend my own, relying upon my experience with gender dysphoria, THT, and medical transitioning. Unfortunately, in the times we live with attacks against *trans people and their healthcare, these questions could not be less theoretical, and more practical. In my view, Butler simply does not believe in the physical validity and medical exigency of gender dysphoria—the primary reason that we transsexuals pursue THT. Thus, in a dissertation that addresses questions of existential urgency and indisputable suffering, I show that Butler's gender theory lacks explanatory power and conceptual coherency, at a time when medically transitioning trans* could not need it more.