Trans activists, to the contrary, rely on a clinical consensus for ‘gender affirmation’ that does not exist.
Trans activists, to the contrary, rely on a clinical consensus for ‘gender affirmation’ that does not exist.
L ast week, Florida’s surgeon general released a memo on the “treatment of gender dysphoria for children and adolescents.” The document seeks to “clarify” assertions made in a Department of Health and Human Services “fact-sheet” about trans-identifying youth. Whereas the HHS document claimed that “early affirming care is crucial to overall health and well-being,” Florida’s one-page summary warns of “low-quality evidence, small sample sizes, and medium to high risk of bias.”
Insofar as the guidelines caution against gender-transitioning drugs and surgeries for minors, Florida is following Europe’s lead. The Florida memo does go further in its explicit caution against social transitions, however.
In 2021, gender-dysphoria experts in the Netherlands — where youth gender transitions were first pioneered — said that “more research is really necessary, and very much needed.” Thomas Steensma of the Center of Expertise on Gender Dysphoria at Amsterdam UMC admitted that “little research has been done so far on treatment with puberty blockers and hormones in young people. That is why it is also seen as experimental.”
In February, Sweden’s National Board of Health and Welfare (NBHW) issued an update on its service guidelines for children and youth with gender dysphoria, citing “uncertain science” and “no definite conclusions about the effect and safety of the treatments” as reasons to conclude that “the risks outweigh the benefits at present.” The Florida memo is accurate, then, in aligning itself with Europe’s increasingly cautious approach: “These guidelines are also in line with the guidance, reviews and recommendations from Sweden, Finland, the United Kingdom, and France.”
Of course, this is not the impression you would get from progressive culture warriors. “The Florida department of health is attempting to demonize life-saving, critical, medically-necessary healthcare for transgender youth,” Daniel Tilley, legal director for the ACLU of Florida, said in a statement.
Similarly, the Washington Post reported that the Florida memo was out of step with “leading medical guidance,” without so much as acknowledging the clinical trends in European countries. The Post’s story insists that the “largest medical organizations in the country — including the American Medical Association, the American Psychiatric Association and the American Academy of Pediatrics,” as well as the Endocrine Society, “have publicly supported gender-affirming care.”
But what of it? The policy statements and guidelines of such medical organizations are typically crafted by a small group of clinicians, and often include politically motivated non-clinicians. (Such was the case for the American Academy of Pediatrics’ 2016 guidelines, which were written by a trans activist with a degree in “women’s, gender and sexuality studies.”) Moreover, the AAP’s 2018 guidelines were thoroughly debunked by clinical psychologist and sexologist James Cantor in the Journal of Sex and Marital Therapy:
Although almost all clinics and professional associations in the world use what’s called the watchful waiting approach to helping gender diverse (GD) children, the AAP statement instead rejected that consensus, endorsing gender affirmation as the only acceptable approach. Remarkably, not only did the AAP statement fail to include any of the actual outcomes literature on such cases, but it also misrepresented the contents of its citations, which repeatedly said the very opposite of what AAP attributed to them.
As Dr. C. Alan Hopewell, the senior clinical neuropsychologist in the state of Texas, explained during the 2019 deposition for the James Younger trial: “Just because an organization takes a stand really doesn’t have anything to do with either science or the membership of the body itself.”
The Washington Post also quotes clinical activist Jack Turban, a fellow in child and adolescent psychiatry at Stanford University, whose methodologies (to say nothing of his unprofessional conduct on social media) have attracted forceful criticism from other researchers.
“The suggestion that social transitions should be avoided for trans youth goes against all existing medical guidelines and data,” Turban told the Post [emphasis added]. Are social transitions, which decrease the likelihood that a child will psychologically reconcile with his or her sex by the end of adolescence, now a one-size-fits-all treatment? Turban seems to think so.
“Refusing to allow a child to socially transition results in shame, damaged relationships between the child and the [provider], and damaged relationships between the child and their parents — all of these result in anxiety, depression and bad mental health outcomes,” Turban also stated.
Which is more compelling? The cautious tone of scientific inquiry, as expressed by the European clinicians, or dyed-in-the-wool ideological certainty? The Florida guidelines recognize and reinforce the principle of “first, do no harm.” They ought to be heeded.