The United States is fast becoming an outlier in paediatric gender medicine. Whereas medical authorities in Sweden, Finland, France, and the United Kingdom have recognised that evidence for the mental health benefits of paediatric transition is weak while evidence for its risks and harms is stronger, the Biden administration’s Department of Health and Human Services (HHS) has now committed itself to promoting the “affirming” model of care.
This model argues that puberty blockers are relatively risk-free, fully reversible, and merely provide users a “window of time” in which to reflect on their identity and decide on next steps. More importantly, it trades on the transition-or-suicide narrative, which suggests that if young people are not allowed to undergo full medical transition, they will be at an extraordinarily high risk for anxiety, depression, and most worryingly, suicide.
Both claims are wrong or at least misleading, but progressive activists and Democratic party leaders seem unable or unwilling to resist them. Thankfully, Florida’s Department of Health just issued a guidance document this week that is meant to be a rebuke to the one issued by HHS. Unlike the HHS document, the Florida guidance is based on a reasonable interpretation of the available evidence, and it more or less aligns with the direction Sweden, Finland, France, and the United Kingdom have been taking on this matter. When it comes to treating gender-related distress in minors, the American Republican Party is much closer to progressive Western democracies, while the Democratic Party, which supports transitioning youth who exhibit proto-gay/lesbian feelings and behaviours, is taking radical steps.
Take the President himself. Addressing “parents of transgender children” earlier this month, President Biden said that “affirming your child’s identity is one of the most powerful things you can do to keep them safe and healthy.” At the heart of this approach is the idea that transgender identity is no less natural or healthy than “cisgender” identity, and that any form of psychological prescreening for hormones assumes that, all things considered, it is better for someone to be cisgender than transgender.
The president’s remarks, which came with no qualifications, are wildly irresponsible and demonstrate the administration’s commitment to gender ideology over science, reason, and common sense. With even leading proponents of paediatric gender transition, including the Dutch researchers who developed the protocol, raising alarm bells about its excesses and dangers, there is simply no excuse for the most powerful man in the world using the most prominent stage in the world to spout pseudoscience.
A number of Republican states like Florida have begun to take matters into their own hands, proposing and in some cases passing bans on paediatric transition. There is a legitimate debate to be had about whether these bans sweep too broadly; according to some researchers, a tiny subset of the population — natal males whose gender distress appears prior to and persists into puberty—can reap long-term mental health benefits from puberty suppression and hormone therapy.
But most minors seeking medical intervention these days are not of this subgroup. Rather, they are mostly teenage girls with no prior history of dysphoria and arrive at gender clinics after prolonged periods of social isolation and exposure to social media.
In March, the DeSantis administration passed the Parental Rights in Education Law. Despite being cynically mischaracterised by progressive activists as the “Don’t Say Gay” law, the bill recognises that transgender “inclusive” and “affirming” policies have concrete and deeply disturbing medical and developmental consequences for children and teenagers.
Assuming it is not held up in the courts (a common fate for legislatures willing to stand up to powerful trans activist groups), the Florida law will probably do more to protect gay and (especially) lesbian students from harm than any law or court ruling in the United States over the past two decades. Florida’s new health guidelines along with its limitation of sex and gender indoctrination in the classroom underscore its emerging status as a leader in the fight to put science and common sense above ideology.