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The dangers of gender-affirmative care American doctors are unnecessarily harming children

First steps on the gender journy. Marcos del Mazo via Getty


July 5, 2022   7 mins

The Biden administration recently announced a plan to ban “conversion therapy” and dismantle barriers to “gender-affirming care” for transgender-identifying children and adolescents. A few days later, Congresswoman Pramila Jayapal introduced the  “Transgender Bill of Rights” on Capitol Hill which sought to legislate what the Biden Administration proposed to impose by executive order.

On this issue, the Democratic Party assumes the mantle of righteousness. Who could oppose “life-saving” “gender-affirming care”? Who supports “conversion therapy”, which the Biden administration described as “a discredited and dangerous practice that seeks to suppress or change the sexual orientation or gender identity of LGBTQI+ people”?

The reality diverges sharply from the loaded language the Biden Administration deploys, lifting terms directly from the most radical trans activists occupying positions at the outermost extreme of an ongoing debate between different factions of gender clinicians.

The dispute over how best to treat gender-questioning children that the Biden Administration seeks to resolve by enshrining “gender-affirming care” and stigmatising “conversion therapy” boils down to whether or not clinicians regard the children in their care as exceptions to everything we know about child development, human biology, sexual orientation, and more. Attending closely to the language of the activists with whom the Biden Administration has sided provides a masterclass in how to manipulate language to normalise risky and invasive medical intervention on a class of people — children — who are widely understood to be unable to provide consent in other contexts.

For exploratory providers, a child’s transgender identification is the beginning of a clinical inquiry that will travel through the individual patient’s biography, their social context, and the templates the culture at large offers that young patients use to make sense of suffering. Nothing magical or transformative happens when a patient experiences gender dysphoria or expresses a transgender identity. Children and adolescents remain children and adolescents. Clinical practice does not overthrow itself when a young patient changes her pronouns.

For affirmative clinicians, on the other hand, the declaration of a transgender identity and the desire for a particular gender presentation suffice. That’s what affirmation means: no further inquiry required. A transfer of loyalty takes place when affirmative clinicians are confronted with “trans” children and adolescents: clinicians’ sense of responsibility shifts from the patient in front of them to the patient’s transgender “alter”. Doctor and patient then collude to slice and drug the patient’s body into compliance with the new identity regime.

Across the Atlantic, countries such as Sweden, Finland, and the United Kingdom are stepping back and shifting away from hormones and surgeries and toward exploratory psychotherapy as evidence of harm mounts. It’s remarkable that the United States government has chosen this moment to double down, without reference to serious inquiries underway at home and abroad.

Rather than bending the arc of history toward justice, the Biden administration has put the full force of the federal government behind a treatment model that amounts to little more than an unregulated medical experiment on vulnerable children and adolescents. Don’t let the language of civil rights fool you.

To understand gender affirmation and the people who push it, we need to take a closer look at their belief in the utterly exceptional “transgender” child. What do affirmative clinicians believe about such a patient, who arrives in their office with a label firmly affixed? Affirmative care starts not with a question or a clinical assessment but with a moral imperative: validate the patient’s transgender identity.

Presented with a “transgender” patient, what else matters? Does a patient’s age or developmental stage matter? What about his or her sex or sexual orientation? What parts of a patient’s life story — or medical history — stand out?

Gender clinicians such as Johanna Olson-Kennedy prefer to talk about gender-questioning three-year-olds as “people”. And they are people. But when we talk about three-year-olds as “people”, rather than toddlers, important information gets lost, with consequences. When we talk about “people”, we think adults. We think autonomy. When we talk about “toddlers,” we think: tiny humans who need constant care and guidance, who cannot be trusted to brush their teeth or cross an empty street, much less start down a medical pathway.

That’s the reason Olson-Kennedy talks about “people” when she’s referring to toddlers. The ideas that underpin gender-affirming care lose their moral force when translated from “people know who they are” to “toddlers know who they are”.

What about sex and sexual orientation? As recently as the mid-2000s, medical providers understood cross-sex identification in childhood and adolescence to be a normal stage of homosexual development, resolving in the majority of cases as the child moved through adolescence and became comfortable with his or her sexual development and sexual orientation. Long before the concept of gender identity took root, the idea of being “born in the wrong body” resonated with many young gays and lesbians — not to mention medical providers, who viewed homosexuals as “inverts” in need of psychological or surgical “correction”.

Affirmative providers overlook, downplay, or outright deny the overrepresentation of same-sex attracted youth among youth seeking transition. But clinicians who rate the “gender presentation” of “transgender” preschoolers on a scale from stereotypical girl (fitted, sparkly, frilly) to stereotypical boy (baggy, sporty) inevitably sweep up children whose rejection of gender stereotypes is rooted in their same-sex orientation. Affirmative providers such as Diane Ehrensaft argue that “prototransgender youth use [same-sex] sexual identity as a stepping-stone toward their transgender true gender self”, a rhetorical move that overwrites the connection between homosexual development and gender dysphoria, and equates accepting your same-sex sexual orientation with pursuing irreversible medical interventions.

Much like their views on same-sex attraction as a “stepping stone” toward a young person’s “transgender true gender self”, affirmative providers treat just about any mental health comorbidities as secondary to gender dysphoria. Suicide attempts, psychotic episodes, anorexia nervosa, depression, anxiety, autism, obsessive-compulsive disorder, experiences of sexual abuse and trauma, and substance abuse aren’t taken as reasons to question or delay transition but instead are treated as evidence for the need to accelerate transition.

In order to grease the skids, affirmative providers have invented or adapted a wide range of new medical concepts, all of which operate to obscure what they do from the public and from providers themselves,  scrambling the complex clinical presentations they need to parse — and manipulating patients, parents, and policymakers. These concepts include “wrong puberty”, “sex assigned at birth”, “reconstructive surgeries”,  and “internalised transphobia”.

Reconceptualising patients as “wrongly sexed” (thus in need of reconstructive relief) and giving allegiance over to the patient’s transgender “alter” over the physical patient and her social and medical history skew clinical assessments and lower clinicians’ barriers to providing experimental medical interventions. Girls become “boys”, not in reality, but in the way gender clinicians talk about reality. Elective double mastectomies on girls become “reconstructive chest surgery” on “boys”. Exploratory therapy to understand where distress over sex and gender originates becomes “conversion therapy,” something no ethical clinician would practice. Drastic, life-altering medical interventions — such as “pausing” puberty and all the cognitive, physical, and emotional development that goes along with it — become conceptualised as non-interventions on the one hand, “life-saving” on the other. In any case, language becomes detached from reality, skewing risk analysis.

This language of determined identities and autonomous “people” speak to the way affirmative clinicians see their role: deferring to patient self-identification and facilitating hormonal and surgical interventions to bring patients’ bodies in line with how they want to “wear their gender”, Meanwhile, activists inside the medical profession push for policy changes to lower the age at which minors can consent to transition — a priority of the forthcoming guidelines from the World Professional Association for Transgender Health — and remove requirements for parental assent. California legislators are on the verge of passing a bill that would equate denial of “gender-affirming care” with child abuse, a move advocates say would turn California into a “sanctuary state” for trans-identifying children.

Ask for stronger evidence or stricter safeguarding measures and you’ll get an earful about suicide and self harm: affirmation is a “matter of life and death.” (Never mind that researchers had to cook bad survey data at extremely high temperatures in order to make such dire claims.)

Affirmative clinicians frequently compare gender dysphoria to endocrine conditions such as diabetes. Take Johanna Olson-Kennedy, dismissing the need to explore the causes of a young person’s distress over gender: “I don’t send someone to a therapist when I’m going to start them on insulin”. Never mind that medical providers can test for diabetes (and monitor whether the treatment is working), while relying on patient testimony to initiate medical transition. Never mind that untreated diabetes kills. Analogies to cancer also abound, especially when clinicians need to justify serious risks like permanent loss of fertility and the very real possibility that patients will lead shorter, sicker lives after medical transition. Ask clinicians and they’ll tell you that gender dysphoria, like cancer, is a life-threatening condition. In the absence of supporting evidence, this is emotional extortion, nothing more.

Affirmative clinicians evade the possibility of regret and detransition. They prefer to talk about “gender fluidity” or “gender journeys”— “journeys” that may include puberty blockers, cross-sex hormones, and elective double mastectomies. Journeys that could not and should not have been avoided, in other words.

Affirmative providers also cleave to a narrow set of explanations about why patients experience regret and detransition, pinning regret and detransition on lack of social support for the patient’s transgender identification. By placing the blame on factors outside the medical system, providers avoid the suggestion that regret and detransition may be the result of inadequate evaluation or inappropriate medical interventions. This interpretation also keeps patients firmly within the ideological framework that underlies affirmative care. Under this framework, a patient remains “really transgender”, even if external factors conspire to keep the patient from living out that identity. Even if the patient disavows their transgender identity entirely.

***

If affirmative providers’ belief in the exceptional “transgender” child bears out, we can make a strong case for affirmation. But if this belief is merely an article of faith, nothing more, clinicians risk doing serious harm to their patients under the banner of affirmation. In other words, if gender-dysphoric children and adolescents are truly exceptions to everything we know about identity formation, child and adolescent development, how humans make sense of distress and their susceptibility to social influence, the role of sexual orientation in gender dysphoria, and more, then affirmation may be the right approach.

But what if supporters of gender-affirming care are wrong?

What if children who identify as transgender are just that: children? What if they hurt, like other children? What if they’re trying to figure themselves out and learn how to navigate the strange world they live in, like other children?

What’s changed are the ideas and expectations that we’ve raised children on and the way we’ve turned them loose in an online world whose terrain no one has mapped. Many of these children have grown up with extended experiences of online disembodiment. They may not be free to run around outside with their friends but they’re free to roam the darkest corners of the Internet. Who knows what strangers and strange ideas they encounter there.

These children have grown up hearing a very new and confusing set of fairy tales about gendered souls that can end up in the ‘wrong bodies’. Adults who should know better — adults who do know better — have made these children impossible promises.

Children who identify as trans aren’t sages. They aren’t sacred. They haven’t been endowed with wisdom beyond their years. It’s not fair to treat them as exceptions to the safeguards we place around children, so that when they grow up and change their minds and ask why we let them do this, we say: You wanted it. You asked for it. You were so sure. What else could we have done?

There’s a way in which everything that touches trans must be exceptional — the children, the stakes, the feelings, the possibility of knowing anything for sure — because if these kids aren’t exceptional, then we threw everything we knew out the window. We didn’t ‘help’ exceptional children but harmed ordinary ones, struggling with ordinary challenges of development, sexual orientation, identity, meaning, and direction.


Eliza Mondegreen is a graduate student in psychiatry and the author of Writing Behavior on Substack.

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John Montague
John Montague
2 years ago

First….do no harm. These people, “doctors” in title only, have forgotten the first premise of medicine and need to be disbarred

Stephen Walsh
Stephen Walsh
2 years ago
Reply to  John Montague

The only doctors likely to be disbarred are those few who oppose them.

William Shaw
William Shaw
2 years ago
Reply to  John Montague

Contrary to what you claim, “these people” are saving lives and lessening misery every day.
Hormone blockers for adolescents have eliminated many suicidal thoughts and gender affirming surgery has brought happiness and joy to almost everyone who undergoes it.

John Montague
John Montague
2 years ago
Reply to  William Shaw

you do know what happens in said surgery don’t you – the actual physical facts of medicalising people for the rest of their lives.

William Shaw
William Shaw
2 years ago
Reply to  John Montague

Yes, absolutely.
Probably better than most of the people posting here.

Johnathan Galt
Johnathan Galt
2 years ago
Reply to  William Shaw

Nope. Pandering to neurosis is not a cure for anything; it simply makes it worse.

Chris Baumgarten
Chris Baumgarten
2 years ago
Reply to  William Shaw

You do know that there is absolutely no scientific evidence that hormone blockers alleviated any suffering at all, let alone prevent teenagers think about suicide. Indeed, even the evidence that “transition” in adults is an effective medical intervention is flimsy at best. You do also know that there is no scientific data at all about people who wanted to reverse their “transition” – at whatever age it took place and to whatever stage it led? Zero. Nothing. (The famous 1 per cent detransitioners are from a very questionable study on a small sample of male adult transsexuals.) So you couldn’t possbly KNOW that “gender affirming surgery” has “brought happiness and joy to almost everyone who undergoes it”. What evidence we have – and that is one recent Swedish cohort study – points to the contrary: Even after “transitioning”, transsexuals continue to have mental health issues and have a widely increased risk of suicide.

Robbi C T
Robbi C T
1 year ago

we’re at an increased rate of suicide because of the people who write this crap and harass us for no good reason. there 100% is info out there on trans peoples mental health after their transition you just gotta google it lmao studies show that in a sample size of 20,000 preop trans people and 5,000 post op trans people they are 44% less likely to have thoughts of suicidal ideation after hormones or surgery or both and that was conducted over a 5 year period

Will Rolf
Will Rolf
1 year ago
Reply to  Robbi C T

It’s interesting that Sweden and Finland have abandoned affirmation therapy and hormone blockers. It’s almost as if these very socialist, progressive countries have been taken over by Right Wing Christian Transphobes. But maybe, just maybe, the medical community in these socialist countries is not motivated by the profits to be made from medicalizing confused kids and decided to do what is best for the children’s well being. It is only ideological zealots who medicalize children in the name of deconstructing gender.

Edward De Beukelaer
Edward De Beukelaer
2 years ago
Reply to  John Montague

It is a general problem in medicine: Rangan Chaterjee expressed quite clearly in a congress recently: there are too many big egos in medicine.
And with that comes too often: i will do this procedure because I can and I find it interesting, with the medical person being honestly convinced that it is in the interest of the patient.
The issue in medicine is that the subjects (patient) are reduced to the ‘illnesses’ determined by a groups of experts (without any input from patients because they are considered to know nothing.) The treatment then aims at fixing the problem .. This is a crude analysis but too often guides medicine, nicely backed up by an industry of illness.
But there is hope: people such as https://collegeofmedicine.org.uk/ are trying to change things…. but it is very slow because many medical people, do not know …. that they do not know what is wrong in medicine…

Johnathan Galt
Johnathan Galt
2 years ago
Reply to  John Montague

Correct. Neither chemical castration nor mutilation are “cures” for any legitimate medical condition.

So called “transgender” folks are absolutely no different than kids who wish they were taller, smarter, prettier, etc. – EXCEPT in their militant demands that the REST of the world participate in their fantasies. Tell ’em to pound sand. If they have a right to an opinion about their gender, so do we.

Men make seeds.
Women make eggs.
Transgenders make trouble.

Robbi C T
Robbi C T
1 year ago
Reply to  Johnathan Galt

what do bigots make? America?

N Forster
N Forster
2 years ago

Underpinning the vast mass of gender ideology sophistry is the belief in a “true self.” Whether there is or is not a true self of any sort is a religious and philosophical matter, not a medical one. So it is unfortunate (insane) that children are being led down a one way street of medical intervention in order to confirm an adults’ belief in a true gendered self. 
This is human sacrifice indeed. Insane.

Last edited 2 years ago by N Forster
B Davis
B Davis
2 years ago
Reply to  N Forster

Not just a ‘true self’…but a true self which only happens to ‘wear’ a body in the same way a man might wear a suit. It is, as they might say, the body ‘assigned’ at birth…and since it’s just a ‘wearable, isn’t it reasonable that someone handed your sacred and separate ‘self’ the wrong suit?
Why of course it is! (to heck with that old-fashioned idea of an embodied self)
And the so-called ‘Care Providers’ are there with a bunch of sharp scalpels and a suitcase full of drugs to get you a different one!

Chris Baumgarten
Chris Baumgarten
2 years ago
Reply to  N Forster

Yes, it is deeply rooted in New Age Esoterics, alongside conventional American Spirituality, who share some common roots. It’s obvious for everyone to see, but people get so baffled by the sophistry and are so used to esoteric claims and capitalist fantasies of “realizing one’s own potential” that they fail to see it for what it is.

Bronwen Saunders
Bronwen Saunders
2 years ago

It seems as if, finally, the tide may be turning. Personally I will vote against any political party that pushes this barbarism. I also hope I live to see the day when the so-called doctors who are currently wrecking so many young lives are locked up for ever – preferably along with all their activist friends.

Brian Villanueva
Brian Villanueva
2 years ago

Bronwen, if you don’t mind my asking, would you have ever voted for the political party that is currently pushing this stuff?

I’m not being nitpicky, I’m really curious whether this trans insanity is pushing otherwise normal liberals to be willing to vote for conservatives. Or if the only people talking this way are fellow conservatives who were always pretty opposed to progressive poilicies.

Last edited 2 years ago by Brian Villanueva
Joann Robertson
Joann Robertson
2 years ago

That is the big question in the current political climate in which there is no middle ground. I’m a Canadian and I have the same problem. I cannot support our current woke government. But I don’t really trust the opposition either.

Leanne B
Leanne B
2 years ago

It did for me. I voted Tory for the first time in my life over this issue. Since then our Labour Party have dug in even deeper. I’ll never vote for them again.

Andy Griffiths
Andy Griffiths
2 years ago

I’m one of them, I cannot vote for any of the alternatives in the UK now – Labour, LibDems, Greens and SNP have all been captured.

Jeremy Bray
Jeremy Bray
2 years ago

“Rather, they are harming ordinary ones who are struggling, as many of us do at that age, with the ordinary challenges of meaning, identity and growing up.”
Indeed. Do no harm is not sexy enough for activist doctors. 

Ian Ryder
Ian Ryder
2 years ago

The trans lobby propagandists have done a very successful job of muddling up words and their meanings. By shoving the ambiguous term gender into every discourse many otherwise rational people seemingly cannot tell the difference between biology and social constructs like manhood or womanhood,
They’re doing the same muddling with ‘conversion therapy ‘. There’s a difference between no longer treating homosexuality as a disease (as it was so defined by the American Psychiatric Association until 1973) and supporting vulnerable teens as they negotiate a minefield of hormonal and social change. Non evidence based ‘treatments’ are no longer inflicted on young and impressionable gay people. We have rightly de-medicalised homosexuality.
But ‘gender-affirming care’ in the sense of this bill is the exact opposite. It’s predicated on the tautological impossibility of being’ born in the wrong body’. We may wish we had been born different, but we are not hardware that can just run alternative software. Our body and minds are inextricably integrated. It’s what makes each of us a unique product of our genetic makeup, whether we like the product or not.
Affirmation processes are not about support. They’re about potentially destructive medicalisation of a non medical problem – how one views oneself. Just because a young person expresses unease about themselves does not mandate drugs or surgery, or even agreement with their viewpoint. If it did we’d be offering anorexics gastric banding, b**b jobs to thin young girls or anabolic steroids to wannabe buff boys.
If mature adults want to sculpt themselves differently that’s up to them. In the meantime young people need protection not medicalisation with non-evidence based interventions whose long term complications are unknown, but which for certain include infertility and the inability to enjoy orgasm.
To offer support to bewildered young people is not conversion therapy. It is compassion.

j west
j west
2 years ago

If all one can do is compare beliefs of the affirmative model to other beliefs, why are these serious medical interventions being done outside of clinical studies???

They don’t have long term outcomes. They don’t have a way to distinguish who has temporary gender dysphoria. Why are these doctors being allowed to proceed?

Last edited 2 years ago by j west
Joseph Ducreaux
Joseph Ducreaux
2 years ago

This article gave me a “eureka” moment when the statement that allegiance is made to the “trans” identity. So if John believes he is “Jane”, then the doctor’s patient is “Jane”.
Why is this done only with gender? If John believes he is Napoleon, why doesn’t the patient become Napoleon?

Julian Farrows
Julian Farrows
2 years ago

“But whoso shall offend one of these little [children] which believe in me, it were better for him that a millstone were hanged about his neck, and that he were drowned in the depth of the sea” (Matthew 18:6; Mark 9:42; Luke …

R S Foster
R S Foster
2 years ago

…second exceptionally good article today…I only hope I live long enough to enjoy the fury and recrimination directed towards the political class and certain quack doctors WHEN the medical malpractice actions, civil suits, criminal charges and utter public shame and disgrace begin to unfold…however they delude themselves, History will remember them as the true heirs of Mengele…

Last edited 2 years ago by R S Foster
Lang Cleg
Lang Cleg
2 years ago

It’s the adultification of children in the service of eugenics, disguised by gnostic language that appeals to the American idea of self reinvention.

Jane Johnson
Jane Johnson
2 years ago

I have a sneaking suspicion that this “gender affirming” treatment will eventually be considered as barbaric as is electroconvulsive therapy for treatment of mental illness. Problem is that in the near term politicians are coming out of the woodwork to endorse affirming treatment of children and teenagers. This is truly disturbing to anyone with an ounce of common sense and concern for the risks of trendy medical treatments.

Charlie Rose
Charlie Rose
2 years ago

If I walked into a doctor’s office and declared I had cancer, they would not immediately and aggressively affirm my self diagnosis and begin chemo and radiation treatment.

If self diagnosis is valid for all mental and physical conditions, then we no longer need to license physicians.

Alphonse Pfarti
Alphonse Pfarti
2 years ago
Reply to  Charlie Rose

A valid point. Walk in and tell them you have cancer and you’ll be sent away, at best diagnosed with some other ailment. Known several people go through this. Most really did have cancer and more than one died of it or only got treatment at a very advanced stage.

Julian Farrows
Julian Farrows
2 years ago

The only conversion therapy going on here is that where children and young adults’ sexual natures are being purposefully malformed. This thread addresses the source and touches upon the possibilities of who or what may be behind it: https://forum.nofap.com/index.php?threads/who-is-behind-sissy-hypno-stuff-and-what-is-their-actual-goal.220974/

Rasmus Fogh
Rasmus Fogh
2 years ago
Reply to  Julian Farrows

To a quick look it seems to be just another variant on BDSM / humiliation / fetish p o r n. Weird, sure, but I would not use it to infer some kind of worldwide conspiracy.

Julian Farrows
Julian Farrows
2 years ago
Reply to  Rasmus Fogh

Maybe not worldwide, but there does seem to be some kind of animus behind the movement to emasculate men. Not just through p0rn, but also through entertainment, news media, and education. A psychologist friend of mine once told me that this is the worst time to be a man since modern times began. At the time, I dismissed his comment as slightly hyperbolic, but over the last couple of years, I’m starting to wonder if there may be some truth to his statement.

Rasmus Fogh
Rasmus Fogh
2 years ago
Reply to  Julian Farrows

This does indeed look like a bad time to be a man. The terms of trade have moved against us in the sexual marketplace, there is not a reliable role to aim for, and press, education and culture seems to be tripping over their own feet to promote women and sexual minorities, for whatever merits they can manage to dig up. But this ‘sissy-hypno’ stuff looks like classic masochism and I really think is consumer-driven rather than producer-driven. If anything the cause and effect go the other way. If you feel that you are unwanted and unvalued and are very unsure of your own worth, this kind of fantasies serve to 1) embrace your own humiliation rather than suffer from it, 2) seeing yourself as someone people desire, even if just for the purpose of using and mistreating you.

Last edited 2 years ago by Rasmus Fogh
Andy Griffiths
Andy Griffiths
2 years ago
Reply to  Rasmus Fogh

It’s an even worse time to be a woman – they’re having the very language they use to describe themselves changed. Note all the references these days to “pregnant people” “cervix havers” “bleeders” “menstruators” etc. Note also that there has been an explosion in the numbers of girls presenting themselves at gender clinics in the last decade.

Arkadian X
Arkadian X
2 years ago

If the good is so “plainly evident”, where is this army of teenage suicides which has plagued humankind since the beginning of time and likely caused the fall of Sparta and of the Roman Empire, to mention but two?

Ian Stewart
Ian Stewart
2 years ago

I’m starting to think the trans lobby is actually a covert Christian movement seeking to convert gays from homosexuality by changing gender, after consulting the Imams of Iran.

After all, the country with the highest rate of transgendered people until recently was Iran, as their Muslim faith won’t countenance homosexuality so they encourage and accept such people changing gender.

Not Saying
Not Saying
2 years ago

Oh, the evidence is there but it’s not discussed in most circles.
https://lauradodsworth.substack.com/p/people-dont-understand-the-trauma
https://pitt.substack.com/
A competent adult may make whatever changes they wish and the consequences are theirs to bear. But for so-called medical practitioners to encourage a child towards this end is abuse, pure and simple.

polidori redux
polidori redux
2 years ago

I don’t mind Americans going bonkers. Well it’s up to them and, anyway, they have always been a bit like that: Take a dumb idea and run with it until you go over the cliff. The best thing about being English is that, having won first prize in the lottery of life, I can afford to laugh at them and their escapades.

Richard Parker
Richard Parker
2 years ago

“Language becomes detached from reality” – yes. That’s the root issue, both here and more broadly in the postmodernist nightmare we’re currently being exposed to on several fronts.

To hardwire it into the future of confused children is pure evil: I’d like to think there’s a special hell reserved for some people, but sadly it’s more likely the victims than the perps who’ll end up suffering. Plus ça change.

Postmodernism was acceptable as a jeu d’ésprit in humanities faculties, but it’s no strategy for a long and happy life, let alone a functioning society.

Rose D
Rose D
2 years ago

In addition to evading the “possibility of regret and detransition,” activists, politicians & affirmative care providers, present an absence of evidence as evidence of absence when it comes to affirmative care.
They say the impact of PB & CSH on fertility is “unclear”; they say that there is “little to no evidence” of PB and/or CSH impacting bone density or brain development; they say the detransition rate is very low.
Can they point to high quality studies that show PBs given to stop puberty before CSH do not negatively impact a child’s development? No. They do not exist.
The same is true for CSH and for the detransition rate.

Nikki Hayes
Nikki Hayes
2 years ago

This too will pass – the forthcoming flood of litigation from trans individuals who have been inappropriately prescribed drugs, or given surgery, will soon make any doctor think twice about going down this road. There should be a better way of ending this insanity but, in the end, money talks.

polidori redux
polidori redux
2 years ago

“What evidence of harm there might be, and frankly there is very little,”
Well quite. What possible harm can come from “doing over” children in the name of the latest fashionable credo to inflict itself upon us? Parents aren’t perfect, but I trust their motives and their judgement before I trust those of the more outre fringe of our medical priesthood.
In York Minster, you can find medieval satirical images in a stained glass window of monkey doctors treating their monkey patients. Perhaps our forefathers had the benefit of greater wisdom.

Last edited 2 years ago by polidori redux
Jim Boddington
Jim Boddington
2 years ago

A GP’s view, as expressed in a recent letter to the British Medical Journal:
https://www.bmj.com/content/376/bmj.o629/rr-1

Jane Watson
Jane Watson
2 years ago

Many many convoluted words. But the sad fact, for the US, is that ‘healthcare’ is big business. More meds, more surgery, more troughs, more piggies. It’s an utter scandal that a surgeon can advertise double mastectomies to children on Instagram. I’ve seen a female surgeon brandishing a 13 yr old victim. Let the lawsuits begin and pray that insurance companies eventually shut down the entire industry.

B Davis
B Davis
2 years ago

I confess.
I am trans-royal.
I know myself to be, deep in my heart of hearts, the King of Siam. My preferred pronoun is ‘Your Majesty’ (and if you could bow slightly when saying that, I’d feel that much more majestic).
I need royalty affirming care! I mean, why not?? If all it requires to be so identified is my declaration then yes, I so declare. So crown me, already!
The author suggests, “what if supporters of gender-affirming care are wrong?”
What if???
What if I’m not and nowhere near the King of Siam?
What if Reality were……..Reality???
In such a place, isn’t confronting me with the disappointing news that ‘NO — you are NOT the King of Siam’, isn’t that better (as measured against that stubborn reality) than playing-pretend for my lifetime and calling me ‘Your Majesty’, and building me a throne…even though by such a denial my feelings might be hurt?
Isn’t it better to tell the so-called gender-confused that ‘No, Little Rich you are Rich….will always be Rich…and will never ever ever become Rachel, no matter what you do to your body, no matter how many people you convince to call you Madame Secretary…the reality which is you, your embodied self, will not change. It is impossible. Boys can’t become girls and girls can’t be boys.
Neither can cats become dogs; oak trees become airplanes; nor cotton become cotton candy (not even if Milo Minderbinder dips it in chocolate & serves it in the Mess Hall). (“Is it really that bad”, asked Milo. “It’s cotton!” said Yossarian). Reality always intervenes
And here and now is where Reality must stand.
Gender affirming care is Politburo DoubleSpeak. What it pretends to affirm is a lie. What it pretends to care for is destroyed. Children who yesterday wanted to be a Dog….are now greeted by this generation’s well-intentioned Mengele’s (aren’t they always)…who stand there Woke & Grinning: Trans Bill of Rights in one hand, and Scalpel & Syringe in the Other…. joyously tapping toddlers on the shoulder, to the left….to the right. Here to affirm, in blood, the terminally unreal.

Brian Villanueva
Brian Villanueva
2 years ago

2012: Gender identity disorder should be treated with therapy.
2022: Gender self-identity must be affirmed and therapy is illegal.
Nothing encapsulates the insanity of the last 10 years better than this. Remember back in 2008 when you were told “your neighbor’s gay marriage will never affect you.” Yeah… Right.

To be clear, I’m not saying it’s causal. Both are consequences of the same societal course change that took place in the 1960’s. Many of the changes since then have greatly increased the individual choices available to particular groups of people (women, gays, trans, drag queens, gimps, puppy fetishees, etc… the groups get weirder and narrower every week) but at the expense of increasingly obvious cultural cohesion and societal dysfunction.

Andy Griffiths
Andy Griffiths
2 years ago

It’s notable that once gay marriage was legalised, Stonewall had to come up with another reason for its continued existence.