Finally, a mainstream academic journal is willing to publish careful scholarship that is strongly critical of experimental pediatric “gender-affirming care.” The liberal party line holds that giving gender-confused children body-changing drugs and surgically removing completely healthy body parts is what is best and “settled science.” It also claims that those disagreeing with this approach are science deniers motivated by transphobia, religious zeal, or simple ignorance. The good people affirm this simplistic conclusion, and those who don’t are very bad. Yes, it is certainly ironic that non-binary advocates have set up such a rigid binary construct for their moral judgements on the matter.

But thankfully this is starting to change.

The Journal of Sex & Marital Therapy has been hosting a very rigorous debate among diverse scholars on the actual state of the research on pediatric gender medicine. This debate is raising serious challenges to the current party line. Just a few important examples of the challenging articles published there are here, here, here and here. (The Archives of Sexual Behavior has also published academic voices opposing gender experimentation on children, just two examples here and here.)

The Journal of Sex & Marital Therapy has just published a new contribution to this important debate, and it is a damning one. The title of the article is direct: “The Myth of ‘Reliable Research’ in Pediatric Gender Medicine: A Critical Evaluation of the Dutch  Studies—and Research that has Followed.” The lead author is from the Society for Evidence-Based Gender Medicine, a very brave cohort of respected medical professionals who are challenging the tragic ideological capture of their profession.

This article specifically interrogates early Dutch research that serves as the foundation for what has become known as “gender affirming care.” This current protocol essentially allows a child or teen with gender confusion to determine for all other adults in the child’s life, including medical professionals, what course of treatment is best for them. All the young person need do is claim to be “gender variant” or “trans” and a whole machine kicks into gear to change the child’s self-understanding and body in dramatically medicalized ways. This fact is well documented.

The authors of this new journal article are rightfully concerned that “‘Affirmative treatment’ with hormones and surgery rapidly entered general clinical practice worldwide, without the necessary rigorous clinical research to confirm the hypothesized robust and lasting psychological benefits of the practice.” They add, “Nor was it ever demonstrated that the benefits were substantial enough to outweigh the burden of lifelong dependence on medical interventions, infertility and sterility, and various physical health risks.”

But still, nearly all of the leading professional health organizations in the United States jumped on the band wagon of injecting drugs and removing healthy body parts from children – what these authors refer to as a “highly politicized and fallacious narrative, created and promoted by clinician-advocates” which “has failed to withstand scientific scrutiny internationally” – because that is what transgender activists have demanded. U.S. medical professionals have swallowed this uncritically, even while their peers in “Sweden, Finland, and most recently in England [are] doing a U-turn on pediatric gender transitions in the last 24 months.” Thankfully medical professionals in Florida have also officially joined this U-turn away from untested and unquestioned experimentation.

These scholars bring a very sobering check on present reality,

The key problem in pediatric gender medicine is not the lack of research rigor in the past — it is the field’s present-day denial of the profound problems in the existing research, and an unwillingness to engage in high quality research requisite in evidence-based medicine. [emphasis in original]

They are precisely right, adding, “In this article, we justify our position that neither the Dutch research, nor the research that followed, is fit for shaping policy or treatment decisions regarding gender dysphoric youth at the population level.”

Of course, this journal article gets into great technical detail on the serious methodological problems with past and present research in this body of research. They summarize their critique in three general categories:

  • High risk of bias: These scholars explain, “The subject selection assured that only the most successful cases at each treatment stage were included in reported results.” That is not science. It is a deceptive sales pitch.
  • Incompleteness of evidence regarding physical health risks of “gender affirmative” treatments: “The Dutch studies [which started all this medical gender experimentation on youth] did not evaluate physical health outcomes of ‘gender-affirmative’ treatments, even though adverse effects of hormonal interventions on bone and brain had been hypothesized from the start (and were confirmed by subsequent research).”
  • Poor generalizability/applicability to current cases: “… [For various reasons] none of the Dutch findings are applicable to most of the youth seeking treatment today.”

These authors conclude with this strong statement, “However, we think the time has come to reexamine the entire 25 years of Dutch experience using rigorous methodologies, to answer the critical question about the full range of risks and benefits of the Dutch protocol… .” They offer five essential suggestions for improving how research conclusions are arrived at on this topic.

This very careful and informed critique of the research underlying “gender affirming medicine” is important when we consider, as these scholars state, that “Youth referrals for gender reassignment have risen already several thousand percent [!] in the last decade, and nearly doubled between 2020/2021 and 2021/2022.”

They add with caution, “If these young patients’ sense of urgency is confused with certainty about their future happiness, while a flawed evidence base is mistaken for proven safety and effectiveness of youth gender reassignment, harm at scale will ensue.”

And it is our precious children that are caught in the destructive teeth of this fouled system of political and ideological activism masquerading as science. These authors are convinced of the fact and say as much,

Another unique aspect of the gender medicine field is that a number of the clinicians tasked with caring for gender-distressed youth have taken on the role of political campaigners – and in doing so, have traded wisdom and nuance for blunt activism.

They continue,

Their insistence that today’s gender dysphoric teens are tomorrow’s transgender adults, and that their future happiness and mere survival hinges on early access to gender reassignment, is demonstrably false.

These scholars finally warn their professional colleagues that in light of this poor research and the wide-spread, unquestioned clinical decisions being made based on it,

The field of gender medicine has a short time to self-correct before a growing number of authorities step in and impose guardrails to safeguard youth. Public health authorities in Finland, Sweden, and most recently England have already done just that…

And authorities in Arizona, Arkansas, Alabama, Florida, and Texas have thankfully realized that pediatric “gender affirming medicine” is a problematic house of cards and have taken their own actions to stand against fashionable, but ill-founded gender experimentation with our children. While some legislation that protects children has been challenged in the courts, at least 20 states have considered similar actions.

And thankfully, we are getting more serious research published in mainstream academic journals telling us that raising such important questions about the current party line is indeed not science denialism.

Rather, it is taking the scientific method seriously, over ideological activism. And that is a very hopeful turn for the sake of reason and our children.


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