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Gender-affirming care, until recently, has been gaining popularity around the world for treating gender dysphoria in children and adults. All that is changing.
The term itself mischaracterizes the treatment. Gender-affirming care is not care. It is chemical and surgical mutilation.
For adults, who can make their own informed decisions, I don’t have much to say other than don’t try to make me pay for such treatments. I consider gender-affirming care to be inhumane medical experimentation more akin to the experiments of Dr. Josef Mengele than a reputable treatment plan.
For children who cannot legally make informed decisions, gender-affirming care should be considered criminal.
In some European countries, there has been a reversal of their views about gender-affirming care as it relates to children in recent years. Finland was the first to pull back. In 2020, the Finnish Health Authority issued new guidelines restricting the use of puberty blockers and cross-sex hormones for minors. This decision was based on a determination that there was a lack of quality evidence to support such treatments for minors.
Before 2020, Finland followed the Dutch Protocol in treating those with gender dysphoria.
The Dutch Protocol was a study conducted 30 years ago that laid out a structured approach to gender-affirming care.
- First, the patients were to be given a psychological assessment.
- Second, if deemed appropriate, puberty blockers might be administered to delay the onset of puberty, giving the patient more time to explore their gender identity.
- Third, if the patient still is experiencing gender dysphoria around age 16, cross-sex hormones would be prescribed.
- Fourth, if gender dysphoria persists, surgery would be considered. Generally, surgery is not provided until the patient is at least 18 and has lived in their affirmed gender for at least two years.
Finnish authorities were reluctant to rely on irreversible measures. In many ways the impact of using puberty blockers and hormone therapy were irreversible. Even before 2020, the Finns preferred to rely on psychotherapy as the first line of treatment. Under the new guidelines, psychotherapy is the primary treatment approach.
Also, in 2020, the UK High Court ruled that children under 16 could not give informed consent for treatment involving puberty blockers. While that ruling was later overturned, it prompted the National Health Service (NHS) to review gender identity services for young people.
In addition to the court ruling, the review was prompted by adults who had received hormone therapy to transition as children but now wanted to detransition. Some were threatening lawsuits because their efforts to return to their birth sex were not fully successful. In England, surgical transitions were very rare.
This review also prompted an in-depth study by Dr. Hilary Cass. In her study, she reexamined the current practices and supporting evidence justifying gender-affirming care for minors.
While Cass’s review was ongoing, the NHS ordered The Gender Identity Development Service for children and young people (GIDS), more commonly known as the Tavistock Clinic, to stop taking on new patients and begin closing down.
However, the final shutdown of the clinic did not occur until earlier this year.
The Dutch started putting the brakes on hormone therapy in 2021 after seeing an increasing number and complexity of cases. Today’s cases differ greatly from the 55 cases examined that led to the Dutch Protocols 30 years ago. In the Netherlands, as in most of Europe, surgeries on children reportedly were extremely rare.
Swedish health authorities updated their guidelines on hormone therapy for minors in 2022. Their review of the literature and the cases in their clinics prompted concerns about the long-term evidence of the effects of puberty blockers and cross-sex hormones on young people. The authorities noted the potential for adverse side effects and the irreversible nature of some treatments.
The Cass Report was finally completed and released in April this year. That study found that scientific support for the Dutch Protocol was “remarkably weak.” Furthermore, she determined that the evidence is insufficient to support continuing to provide hormone therapy to minors.
Uniformly, European health authorities are pulling back on their support for gender-affirming care in favor of psychotherapy. In the United States, we remain widely polarized.
In some states like Florida, Alabama, Arkansas, Texas, Tennessee, and Mississippi, authorities have restricted or are moving to limit hormone therapy and surgeries for those under 17 or 18. In other states, like Illinois, California, Minnesota, Maryland, Colorado, New Jersey, New York, Oregon, and others, the government’s position has been to promote and support gender-affirming care for minors. The federal government still insists that gender-affirming care for minors is settled science.
Despite the severe polarization of positions here and internationally, all the key research supports the position that psychotherapy, instead of hormone therapy and surgery, is the way to treat gender dysphoria. More and more medical and psychological experts are coming around to that position. Government officials, too, are being swayed by the evidence.
Unfortunately, the true believers of gender-affirming care are not letting go of their narrative. They refuse to examine the evidence and continue churning out propaganda to support their position. There is no convincing them that people cannot be born in the “wrong body.”
This false narrative has captured at least three major institutions: the British Medical Association (BMA), the American Medical Association (AMA), and the American Psychological Association (APA). All three groups have launched campaigns to promote gender-affirming care, and progressive activists have clearly captured the administrations of all three groups.
In addition, the entire Democrat Party has taken a position in support of the false narrative.
Individually, these groups each wield significant power. Together, they hold tremendous power, and the Democrats currently control two branches of our government.
The question is, will the power of the false narratives these groups promote outweigh the unassailable evidence in studies like the Cass Report?
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