We are real: Sexuality, gender and the problem of ontology in US health education

Background: Far-right movements in the USA have increasingly opposed inclusive health education by deploying arguments that delegitimize LGBTQIA+ identities. These arguments often conflate ontological and epistemological claims, positioning gender and sexuality diversity as ideological rather than legitimate aspects of human experience. Objective: This article critically examines the ontological assumptions underlying far-right arguments against sexual and gender diversity in health education. It aims to expose the epistemic fallacies in these arguments and to provide health educators with philosophical tools to resist them. Methods: Drawing on critical theory and philosophical analysis, the author dissects far-right discourses, focusing on the rhetorical use of concepts like “gender ideology.” They employ Roy Bhaskar’s concept of epistemic fallacy to differentiate between ontology (the nature of being) and epistemology (ways of knowing). Results: The analysis reveals that far-right arguments rely on a conflation of epistemology and ontology to invalidate LGBTQIA+ identities. These arguments often rest on Christian theological assumptions disguised as objective science, weaponsising bodily materiality to maintain heteronormative power structures. Conclusion: Health educators should recognise the difference between epistemological and ontological claims and resist far-right rhetorical tactics. Acknowledging that health education primarily concerns epistemological work, educators can foster inclusive and safe learning environments while navigating conflicts of belief and values.