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Trans scepticism makes its way home to the Netherlands

A trans rights protestor in Amsterdam last year. Credit: Getty

November 25, 2023 - 8:00am

Scepticism of youth transgender medicine, which has been a major point of discussion in the UK and US for years, has finally made its way back to the Netherlands, as observed this week by the Society for Evidence-based Gender Medicine (SEGM). 

The Netherlands has long been the epicentre of transgender medical research, and its guidelines for youth gender transitions have become a model for other Western countries, where demand for such procedures has skyrocketed over the past decade. 

Two major stories have cast this research into doubt. A publication in the Dutch Journal of Medicine earlier this month offered a scathing critique of clinical guidance on youth gender medicine published in the same journal, arguing that it failed to acknowledge the lack of evidence supporting such interventions, failed to mention the fact that puberty blockers can impede the process of reflection which the drug is supposed to support, and misrepresented the literature on puberty blockers’ impact on brain development, among other issues. 

A Dutch public broadcaster, meanwhile, recently released a two-part documentary critical of youth gender medicine, sparking a large public debate. The documentary critically assessed the scientific basis for youth gender medicine and the effect of puberty blockers on children’s brains, and it inspired a wave of criticism and debate from Dutch trans activist groups. 

Now, the legal premise for adolescent gender medicine is also under fire in the Netherlands, according to SEGM. A paper published in a Dutch medical journal earlier this year argued that the 2018 Dutch Protocol, the official Government guidance on youth gender medicine, does not meet the qualifications to be considered standards of care. Standards of care must be evidence-based, have a limited ethical dimension, and be created in a properly designed process.

These findings are significant because it was the Netherlands which laid the foundation of youth gender transitioning. Published in 2011 and 2015, two studies (knows as the Dutch Studies) found that puberty blockers, cross-sex hormones and surgeries were an effective treatment for gender dysphoria, forming the foundation of paediatric transgender medicine throughout the Western world and inspiring the medical transitions of thousands of minors at mainstream medical institutions.

As concerns have grown over the safety and efficacy of cross-sex medical treatments and several countries have moved to restrict the procedures, the Dutch studies themselves have come under scrutiny for methodological issues and bias. The Dutch studies were the sole source of research behind the Endocrine Society’s statement in support of puberty blockers for gender dysphoric youths and the seventh version of the World Professional Association for Transgender Health (WPATH) Standards of Care guidelines, which were in place during the explosion in youth transgenderism. 

The prevalence of transgender identification expanded in the following decades, particularly among teenagers who were natal females; prior to 2000, patients with gender identity issues were almost exclusively male. Referrals to the UK Gender Identity Development Service rose from 94 in 2009-2010 to nearly 1,000 in 2015-2016. Many critics have argued this is evidence that transgender identification is a social contagion rather than an enduring, innate condition, and thus would be better treated with therapy than permanent biomedical interventions. 

Efforts to restrict youth gender transitions have been painted as Right-wing, religious and anti-scientific in nature. But as transgender care and the body of research behind it collapse under international scrutiny, that line will become increasingly difficult to toe. With each nation that restricts these treatments and each paper critiquing the evidence for trans medicine, youth gender medicine comes to appear more fringe, experimental and dangerous. 


is UnHerd’s US correspondent.

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Ewen Mac
Ewen Mac
11 months ago

That’s good news for autistic kids, kids who’ll turn out to be gay or lesbian, tomboys or any kid who enjoys the “wrong” hobbies for their sex. It’s also good news for the tiny number of kids who get gender dysphoria (as opposed to the recent wave of ‘social media contagion’ cases). They might actually be told the truth which is that the vast majority of kids grow out of it, as opposed to telling them they have some fluffy, indefinable inner “essence” that doesn’t match their genitals and that’s why their favourite author hates them.
If we had a functioning media sector it might have kicked off a debate here but they’re probably waiting until it’s they feel it’s safe to raise the subject. Such fearless journalism.
Likewise our politicians, most of whom are currently too scared to speak on behalf of rationalism.
Couple that with the growing number of lawsuits facing US “trans care providers” and this dumb, dangerous fad might start to wane.

Last edited 11 months ago by Ewen Mac
Martin Smith
Martin Smith
11 months ago
Reply to  Ewen Mac

Insane that, in an era where restrictive gender stereotypes have loosened to allow broad acceptance of females in formerly male roles, there should be reaffirmation of these very same stereotypes by people claiming that gender itself, not just associated role models, is entirely socially determined. If that was indeed true a ‘wrong’ body would be an impossibility, even as a thought.

David Morley
David Morley
11 months ago
Reply to  Martin Smith

people claiming that gender itself, not just associated role models, is entirely socially determined.

Thats actually the mainstream feminist position. Some trans activists, following Judith Butler, have accepted and radicalised this notion. Others, while still using the term gender (or gender identity) see this as innate, but not inevitably tied to physical sex.

While supporting more or less the same political position, these are almost opposite theoretical positions. One leans massively nurture, the other massively nature.

William Brand
William Brand
11 months ago
Reply to  Martin Smith

Gender behavior is programmed into the genes by evolution. A female’s prime function is to care for and produce babies. A female cannot occupy any profession that takes her away from that baby. Among hunter gathers women searched for plant food with a baby on her back while men were free to hunt for meat. Hunting would have caused her to leave baby alone which leads to a dead baby an evolutionary bad decision. Older women are free to assist as grandmothers and take on male functions. A woman still has to quit her job and depend on a male until her youngest is old enough to latchkey. Any other decision results in no children to take care of her in old age and she should not count on social security. It’s bankrupt. A male’s ideal situation is to impregnate multiple females and get out of child support leaving the women with all costs of child raising. This leads to a lot of dead babies. Lower status males will take a wife and support the child since they cannot play the “Love them and leave them” game. The woman wants a HI status stud with superior genes, but such are chasing other females and tend to not support their numerous bastards. She settles for a dad but wants that Stud as a sire. A male needs assurance that any children that he supports are his. Laws punishing female adultery with death arise due to the male fear of females violating their promise not to stick the husband with supporting some Stud’s b*****d. Male adultery is rarely punished because the stud is usually rich and powerful and therefore above the law.

Studio Largo
Studio Largo
11 months ago
Reply to  Ewen Mac

Yeah, we’ll see. While it’s good to see movement away from this grotesque insanity, we need far stronger pushback than ‘maybe we overprescribed’. NO ONE should be given puberty blockers, period. If delusional adults choose to have their genitals mutilated, go ahead but the idea of this being done to children is monstrous. If we’re too weak and cowardly to protect children from these sick bastards, what worth do we have as men and women?

R M
R M
11 months ago

It is utterly extraordinary to me that anyone, never mind medical professionals, would ever think that irreversible surgery and hormonal treatment is the correct way of treating children with a mental health illness.

How on earth has any of this passed any kind of ethical test?

Nathan Sapio
Nathan Sapio
11 months ago
Reply to  R M

Especially when you consider it comes from the same set of people who worry about organic foods, GMOs, veganism, etc who want to maximize purity and naturalism for everything regarding the human body.

Somehow artificially messing with the building blocks of your body and intervening in critical natural processes with radical substances gets a pass.

Jim Veenbaas
Jim Veenbaas
11 months ago
Reply to  R M

Do we really need studies to prove that blocking puberty is a bad thing. When does common sense enter the picture?

Last edited 11 months ago by Jim Veenbaas
Caty Gonzales
Caty Gonzales
11 months ago
Reply to  Jim Veenbaas

Ha… I remember one of my tutors telling our group that his alarm bells went off whenever he heard anyone arguing a point from ‘common sense’. Naturally, he was tutoring us on postmodern theory.

Martin Smith
Martin Smith
11 months ago
Reply to  Caty Gonzales

What kind of tutor gives his or her opinion on a contentious issue? A tutor’s role is to bring out a particular author’s argument or encourage the student to develop his or her own. Indoctrination is not education.

Aphrodite Rises
Aphrodite Rises
11 months ago

So all the people who have used being on the right side of history as a weapon in the debate are actually on the wrong side of history.

Last edited 11 months ago by Aphrodite Rises
Huw Parker
Huw Parker
11 months ago

Indeed. As an argument, this goes right through mere irony and out the other side. I particularly enjoyed this observation: 
‘Efforts to restrict youth gender transitions have been painted as Right-wing, religious and anti-scientific in nature.’
So, while gender transition itself denies the reality of biology, efforts to restrict it are painted as anti-scientific. I’d be inclined to argue that you couldn’t make it up, but of course that’s exactly what has happened.

Aphrodite Rises
Aphrodite Rises
11 months ago
Reply to  Huw Parker

Yes, they have tied themselves up in logical knots and the only way to break free requires them denouncing themselves: becoming heretics. Hence the aversion to debate. They are the monsters that shrivel up and die when exposed to the light of reason unless they manage to extinguish the light or crawl under a rock and hide in time.

Last edited 11 months ago by Aphrodite Rises
Mangle Tangle
Mangle Tangle
11 months ago

Wrong side of science, for sure, and on the wrong side of the oath, ‘First, do no harm.’

David Morley
David Morley
11 months ago

Not necessarily. History seems to be as happy building itself on myth as on fact. Perhaps more so. Time will tell whose side history is on.

Whose side the facts are on is something else.

Aphrodite Rises
Aphrodite Rises
11 months ago
Reply to  David Morley

Assuming the facts are not suppressed, history will record the deceptions of practitioners (claiming puberty blockers are reversible and that it is possible to change sex) and the mutilation of children’s bodies. I do have faith that eventually ‘truth will out’. It is true that it’s a complex ‘web we weave, when we start to deceive’. The contradictions and lies will become more obvious until they cannot be denied.

Last edited 11 months ago by Aphrodite Rises
Daniel P
Daniel P
11 months ago

Yep. That about sums it up.

Dionne Finch
Dionne Finch
11 months ago

I live on a small Island off Vancouver. My son’s elementary school just put up a large trans flag, the United Church painted their entrance in trans colours and the bakery is also adorned with the trans flag. I met with the school Principal and communicated my concerns with the church pastor and it was apparent that they had no idea of the dark side of this ideology. Despite my best efforts I did not manage to affect change, I only succeeded to make two important community members to consider me a transphobic bigot.

Noel Chiappa
Noel Chiappa
11 months ago
Reply to  Dionne Finch

“There are none so blind as those who will not see.”
Since you’ve already been labelled a transphobic bigot, you might as well walk with a protest sign calling for the sterilization of trans children. If anyone complains, you can point out to them that you’re calling for the exact same thing as the trans community.

Jim Veenbaas
Jim Veenbaas
11 months ago
Reply to  Dionne Finch

Maybe a good approach would be asking them to put up an Israeli flag. When they reject the idea, you can then ask them to justify the discrepancy.

Studio Largo
Studio Largo
11 months ago
Reply to  Dionne Finch

The hell with them, you’re doing the right thing.

Leejon 0
Leejon 0
11 months ago
Reply to  Dionne Finch

And sadly once this grotesque fad has run its course, and they turn to the next one, they will still not forgive you. Your crime is not your rational sense, but your perceived heresy. But on a positive note, history usually remembers the heretics, the pious are always just an amorphous blob.

N Satori
N Satori
11 months ago

Referrals to the UK Gender Identity Development Service rose from 94 in 2009-2010 to nearly 1,000 in 2015-2016. Many critics have argued this is evidence that transgender identification is a social contagion 

Just as 21st century ease of travel facilitates the spread of viral contagions so that other great technological achievement, the internet and social media, has opened the way to the rapid spread of social contagions. Do we need a ‘vaccine’ for the mind?

Adrian Smith
Adrian Smith
11 months ago
Reply to  N Satori

“Do we need a ‘vaccine’ for the mind?”
It’s called education. If students at all levels were taught to think critically, rather than being spoon fed woke nonsense, then there would never have been a problem. The government has promised guidelines for schools but, like a lot of other politician promises, they have not been delivered.

N Satori
N Satori
11 months ago
Reply to  Adrian Smith

I respectfully disagree.
We must ask who is doing the educating and what is the belief system that guides the critical thinking they seek to impart? How many people really have the time and the intelligence to think critically anyway? Also, how do you overcome the seductive power of an emotional response to life’s events?

Julian Farrows
Julian Farrows
11 months ago
Reply to  N Satori

As a long-time teacher, I can tell you that much of the education system has been co-opted by progressive useful idiots, particularly among those who dictate policy.

UnHerd Reader
UnHerd Reader
11 months ago

We should stop calling it “gender affirming” treatment. It’s “gender changing” treatment and should be described as such.
Everybody likes to “affirm” a teenager, so “gender affirming” sounds fairly innocuous. But changing a teenagers gender is self-evidently a very serious matter.

Aphrodite Rises
Aphrodite Rises
11 months ago
Reply to  UnHerd Reader

They are not trying to change the gender, they are actually attempting to change sex which is impossible. People should stop using the word gender when they mean sex.

Last edited 11 months ago by Aphrodite Rises
Katja Sipple
Katja Sipple
11 months ago

I recall an anecdote about one of those confused individuals who genuinely believed that his operation would turn him into a woman and provide him with two X chromosomes and the ability to give birth! If true, and I cannot verify that, this incident proves how gullible and ignorant these people are. I don’t even want to unravel the whole disaster that is the medical community which may reinforce such beliefs and give these misguided individuals false hopes.

Jerry Carroll
Jerry Carroll
11 months ago

The depraved want to create more of themselves because they are lonely and want acceptance. Trans people, only .003% of the population, and the movement to normalize their abominations it is led by the left and its boosters in the news media.

John Bourke
John Bourke
11 months ago

The paper on standards of care is a direct attack on WPATH. It has been long said that WPATH’s standards of care were not up to a professional level of quality.

Adrian Smith
Adrian Smith
11 months ago
Reply to  John Bourke

WPATH and EPATH are just a group of medics who are more interested in affirming their own twisted views than they are in actually caring for patients.

N Satori
N Satori
11 months ago

Though they’d never face up to it there is a possibility that feminism is the root cause of this transgender mania. Weren’t they the ideologues who originally insisted that, apart from reproductive organs, there is no important difference between men and women? Such differences as there are must be mere social constructs to be ‘educated’ away.

David Morley
David Morley
11 months ago
Reply to  N Satori

there is a possibility that feminism is the root cause of this transgender mania

More than a possibility. “Deconstructing” gender was and is a feminist imperative and it’s been active in education for decades.

Leaving aside the possibility of some chemical/hormonal cause – which can’t be ruled out – feminism is by far the most obvious cultural factor which might have given rise to the trans phenomena.

Peter Johnson
Peter Johnson
11 months ago
Reply to  David Morley

Feminists also conditioned people into saying they believed things which they know are nonsense – or suffer being attacked and cancelled. So we get this nonsense that the only reason boys and girls are different is a sexist society. Which no one actually believes.

Rae Ade
Rae Ade
11 months ago
Reply to  N Satori

I thought feminism was about wanting equality of opportunity, in particular jobs, careers, pay etc. That broad gender stereotypes shouldn’t place a limit on what a woman or for that matter a man, can do. Seemed pretty positive.

N Satori
N Satori
11 months ago
Reply to  Rae Ade

If only it had remained so rational!

UnHerd Reader
UnHerd Reader
11 months ago
Reply to  Rae Ade

Yes I too believe that that’s what it is

Katja Sipple
Katja Sipple
11 months ago
Reply to  Rae Ade

Yes, that was/is my kind of feminism. This extraneous rubbish about denying biology and social engineering is the reason why I no longer use the term for myself. The basic and very positive tenets of feminism have been hijacked by radical ideologues who endeavour, and have largely succeeded, to undermine and redefine society. Unfortunately, the masses have not yet awakened. The vast majority of those who call themselves feminists are simply bleating sheep who believe themselves to be on the right side of history and/or cowards who fear social repercussions. I also doubt that most women who proclaim feminist beliefs truly understand how far the movement has deviated from its roots.

Andrew Thompson
Andrew Thompson
11 months ago

1) Male. 2) Female. 3) Mental health issues.

Noel Chiappa
Noel Chiappa
11 months ago

There actually are a vanishingly small number of people with biological gender issues, e.g. Caster Semenya. Not everyone is XX or XY; XXY (Klinefelter syndrome) occurs in about .1% of babies.

Arkadian Arkadian
Arkadian Arkadian
11 months ago

What is the law in the NL at this moment in time, for example, can you change sex on a whim? And what is the prevalence of “affirming” care, are the numbers up, down or constant?

Daniel P
Daniel P
11 months ago

Once again, this proves that the common sense of the masses tends to identify quackery in academia.

If asked, I imagine that the vast majority of people, if they answered honestly, have considered the Trans wave an academic and internet inspired boondoggle, fed by a wave of teen depression in response to social media usage and Covid lockdowns. They would also call out the response to that with medical intervention, an obscene practice fueled by the desire of some in the medical profession to profit either directly through performing procedures or indirectly by becoming lecturers and pundits etc. I suspect that they would also call the intervention by government via educators, social service and the courts, between parents and their children, not just frightening but vile.

We can only hope that this research and the various ongoing investigations into this lead to massive lawsuits that decimate those who propagated this obscenity.

Bruce Levitt
Bruce Levitt
11 months ago

Better late than never, but thousands of lives ruined. The devious practitioners must face long prison terms.

William Brand
William Brand
11 months ago

Male sexual misalignment and gay behavior is due to over presence of estrogen in mothers body blocking the normal reset of the brain in males. The brain’s default is female. The presence of male hormones in the fetus causes a reset to heterosexual male. Until Woke came out, most requests to change gender came from males. Female to male sex change is due to the innate female extreme susceptibility to fads and fashions. I remember a commercial showing a woman looking at the clothes she wore as a teen and saying, “What was I thinking.” She was just following a fashion of the time. A normal female trait. Now Tomboys and young lesbians are asking for puberty blockers, male hormones breast and uterus removal at taxpayer expense. Following this fad is far worse than getting a tattoo. It’s not easy to reverse the fashion. When they grow up, they find that they have destroyed their bodies. Then they want breast implants and surrogates in order to reverse their unwise surgery, all at taxpayer expense. They need to sue the woke propagandist billionaire George Soros for creating the Woke fad that destroyed their bodies.

Katja Sipple
Katja Sipple
11 months ago
Reply to  William Brand

There is no male or female brain! This nonsense has been disproven by science long ago. As for following fashion, that is also something done by women and men. I am certain that many a man looks at his teenage photos with a twinge of regret and a bit of a wince at clothing and hairstyle choices.