An appellate judge in Montana blocked the state’s law preventing minors from undergoing transgender medical interventions, marking the latest salvo in a national battle over whether children should be allowed to medically “change” their gender.
Often, this issue is presented as being about trans-ideology and ensuring people who identify as transgender are treated equally under the law. Consider the following examples from the Montana case alone:
- In his ruling, Judge Jason Marks concludes, “The legislative record is replete with animus toward transgender persons, mischaracterizations of the treatments proscribed by SB 99 and statements from individual legislators suggesting personal, moral or religious disapproval of gender transition” (p. 34).
- The American Civil Liberties Union (ACLU) described Montana’s law as “hateful” in a press release praising the ruling.
- The New York Times’ latest round-up of state gender policies described “supporters of transgender rights” in its subtitle as people trying to “convince judges that transition care for minors was safe” and included a break-out section of new gender rulings entitled, “The Anti-Trans Push in America.”
The underlying message is clear — if you oppose letting children undergo medical gender “transitions,” you must hate people who identify as transgender and want to take their legal rights.
This is an effective, if disingenuous, strategy to discount critics’ perspectives as hateful. It’s easy to dismiss the arguments of “bad” people without testing their merit.
In reality, the debate over so-called gender-affirming care for children has little to do with trans-rights and ideology, and everything to do with child welfare. Critics do not have to be hateful, opposed to the transgender social agenda, or even religious, to understand evidence that opposite-sex hormones, puberty blockers and transgender surgeries are physically and mentally damaging for kids.
Supporters of children medically “changing” genders typically argue puberty-blockers and opposite-sex hormones don’t harm minors’ physical and mental development. The often cite studies showing the mental health of gender-confused children improves after they start medically “transitioning” to their chosen gender.
But these findings don’t track long-term outcomes of opposite-sex hormones and puberty blockers. An oft-cited 2022 study found 315 gender-confused American children were less anxious and depressed than their peers after taking opposite-sex hormones — but scientists drew their conclusions after only two years.
Investigations of Western European transgender clinics and testimony from whistle blowers like clinic worker Jamie Reed also suggest facilities prescribing transgender medical interventions aren’t keeping track of the amount of patients who “detransition” back to their biological gender after taking hormones and puberty blockers or getting surgery.
Some of these detransitioners are now vocal critics of allowing children to medically “change” their gender.
Additionally, early research, like a seminal six-year study from the Netherlands in 2011, doesn’t apply to the new demographic of gender-confused children. As early as 2015, researchers from Finland raised concerns the number of gender-confused children was increasing and most new patients were girls with pre-existing mental health problems, as opposed to the 2011 study’s sample of mostly boys.
The researchers’ observations reflected a global trend. Reed, who spent four years working as a case manager for The Washington University Transgender Center at St. Louis Children’s Hospital, told The Free Press:
“Until 2015 or so, a very small number of (young boys who wanted to be a girl) comprised the population of pediatric gender dysphoria cases. Then, across the Western world, there began to be a dramatic increase in a new population: Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone. I certainly saw this at the center. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls.”
Concerns about insufficient research are often ignored because, as Marks wrote in his Montana ruling, “the medical community overwhelmingly agrees that (cross-sex hormones, puberty blockers and transgender surgeries) are the accepted care for treating gender dysphoria in minors” (p.38-39).
The truth is more complex. American medical associations started supporting transgender medical interventions for children after Western Europe implemented them. But now, these trailblazing countries — Finland, Sweden, France, Norway and the U.K. — are rapidly rolling back their support of such “treatments.”
Finland revised their medical guidelines to exclude puberty blockers from the “first line of care” for gender-confused children in 2020. Sweden’s National Board of Health and Welfare followed suit two years later, saying hormones and puberty blockers should only be used in exceptional cases. The National Academy of Medicine in France strongly cautioned against transgender medical interventions the same year, citing concerns about their physical and mental side-effects:
“Although, in France, the use of hormone blockers or hormones of the opposite sex is possible with parental authorization at any age, the greatest reserve is required in their use, given the side effects such as impact on growth, bone fragility, risk of sterility, emotional and intellectual consequences and, for girls, symptoms reminiscent of menopause.
“As for surgical treatments … their irreversible nature must be emphasized.”
The Academy’s release also noted differences between what they call “’structural’ gender dysphoria” and “gender dysphoria” that goes away after a child grows up, writing, “The risk of over-diagnosis is real as shown by the increasing number of transgender young adults wishing to detransition.”
Norway and the U.K made similar findings in their 2023 investigations, concluding transgender medical interventions and their effects on processes like growth, bone density and cognitive development were under-researched.
Both investigations found doctors were lax and inconsistent in how they prescribed interventions like cross-sex hormones. The U.K. review found staff at the country’s premier transgender “treatment” program felt pressured to put children on puberty blockers and cross-sex hormones in an “unquestioning affirmative approach.” They further concluded gender-confused children presenting with multiple mental illnesses were often only given hormones for gender-confusion with their other illnesses left untreated.
The U.K.’s investigation once-prestigious Tavistock clinic to close.
These procedural problems aren’t relegated to Europe. Reed, whose claims were verified by the Times after months of vilification from mainstream media, alleges one or two visits to an approved psychologist and one visit to an endocrinologist was all it took for the clinic she worked at to put a child on opposite-sex hormones or puberty blockers. Increasingly, Reed recalls, in-patient psychological facilities referred children to Reed’s clinic for gender-confusion treatment, regardless of the other medicines they were on. When she raised questions about the clinic’s ethics, Reed received negative performance reviews.
This is but a brief overview of the mountains of evidence showing transgender medical interventions — and the way we administer them — are bad for children. When supporters of children medically “changing” their gender call critics “anti-trans” or “hateful,” it suggests their views are theoretically or theologically motivated, when this is far from the case.
If anything, the evidence is compiled by organizations and people that otherwise support trans-ideology. Though their findings corroborate Christians’ view that God intentionally creates people male or female, no one can accuse these groups of shoving religion down people’s throats.
The debate over transgender medical care for children is about medicine, and whether subjecting confused children to experimental, unproven medical interventions that derail the rest of their lives.
It shouldn’t be a hard side to take.
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