One sign that there has been a sea change in America’s gung-ho enthusiasm for “affirmative care” of minors with gender dysphoria is the mainstream media’s recent critiques (or just objective analyses) of the problems with such care. These critiques have exposed the lies promulgated about such care, largely by the “progressive” Left. The new article in The Atlantic by staff writer Helen Lewis is one such journalistic corrective (read it by clicking on the screenshot below or by reading it archived here). And you should read it.
One of the factors prompting the article appears to have been the Supreme Court case The United States v. Skrmetti, which upheld a Tennessee law banning the use of hormones or puberty blockers for “gender affirming care” in cases of gender dysphoria in minors. Such care was allowed, however, if modification of sexual traits was necessary to allow an individual with a disorder of sex determination to “conform to their sex assigned at birth” (Wikipedia’s words, not mine). The case was decided along ideological lines by a 6-3 vote, but in general I agreed with the decision, having felt that medical treatment for transition should be permitted only if a person with gender dysphoria was old enough to have mental maturity to decide. (I waffle between 16 and 18 on this one, but it’s 18 in Tennessee).
Author Lewis, in fact, was willing to allow medical transitioning to begin in younger children with dysphoria, but changed her mind after seeing WPATH, progressives, doctors, and government officials repeatedly lie about the condition and how to fix it. To quote her (all the article’s quotes are indented):
I have always argued against straightforward bans on medical transition for adolescents. In practice, the way these have been enacted in red states has been uncaring and punitive. Parents are threatened with child-abuse investigations for pursuing treatments that medical professionals have assured them are safe. Children with severe mental-health troubles suddenly lose therapeutic support. Clinics nationwide, including Olson-Kennedy’s, are now abruptly closing because of the political atmosphere. Writing about the subject in 2023, I argued that the only way out of the culture war was for the American medical associations to commission reviews and carefully consider the evidence.
However, the revelations from Skrmetti and the Alabama case have made me more sympathetic to commentators such as Leor Sapir, of the conservative Manhattan Institute, who supports the bans because American medicine cannot be trusted to police itself. “Are these bans the perfect solution? Probably not,” he told me in 2023. “But at the end of the day, if it’s between banning gender-affirming care and leaving it unregulated, I think we can minimize the amount of harm by banning it.” Once you know that WPATH wanted to publish a review only if it came to the group’s preferred conclusion, Sapir’s case becomes more compelling.
Here are three of the issues that Lewis raises:
1.) Lying or misleading people about gender dysphoria and its treatment.
ACLU lawyer Chase Strangio was guilty of promulgating the lie that failure to effect gender transition in dysphoric children would lead to their suicide. He in fact made this statement when he argued Skrmetti before the Supreme Court, and had to admit under questioning that there was acxtuallyno evidence for this assertion:
“We often ask parents, ‘Would you rather have a dead son than a live daughter?’” Johanna Olson-Kennedy of Children’s Hospital Los Angeles once explained to ABC News. Variations on the phrase crop up in innumerable media articles and public statements by influencers, activists, and LGBTQ groups. The same idea—that the choice is transition or death—appeared in the arguments made by Elizabeth Prelogar, the Biden administration’s solicitor general, before the Supreme Court last year. Tennessee’s law prohibiting the use of puberty blockers and cross-sex hormones to treat minors with gender dysphoria would, she said, “increase the risk of suicide.”
. . . But there is a huge problem with this emotive formulation: It isn’t true. When Justice Samuel Alito challenged the ACLU lawyer Chase Strangio on such claims during oral arguments, Strangio made a startling admission. He conceded that there is no evidence to support the idea that medical transition reduces adolescent suicide rates.
At first, Strangio dodged the question, saying that research shows that blockers and hormones reduce “depression, anxiety, and suicidality”—that is, suicidal thoughts. (Even that is debatable, according to reviews of the research literature.) But when Alito referenced a systematic review conducted for the Cass report in England, Strangio conceded the point. “There is no evidence in some—in the studies that this treatment reduces completed suicide,” he said. “And the reason for that is completed suicide, thankfully and admittedly, is rare, and we’re talking about a very small population of individuals with studies that don’t necessarily have completed suicides within them.”
Here was the trans-rights movement’s greatest legal brain, speaking in front of the nation’s highest court. And what he was saying was that the strongest argument for a hotly debated treatment was, in fact, not supported by the evidence.
Strangio is one of the biggest proponents of affirmative care, and even took to Twitter advocating censoring Abigail Shrier’s book on gender dysphoria, Irreversible Damage. (Strangio is a trans-identified female.) Imagine an ACLU lawyer advocating censorship!
The “Dutch Protocol” (see below) was often cited by American organizations like the World Professional Association for Transgender Health (WPATH) or by physicians to justify affirmative care of minors. But the Dutch Protocol (affirmative care with medical intervention in children of younger ages) is basically without convincing clinical evidence:
Perhaps the greatest piece of misinformation believed by liberals, however, is that the American standards of care in this area are strongly evidence-based. In fact, at this point, the fairest thing to say about the evidence surrounding medical transition for adolescents—the so-called Dutch protocol, as opposed to talk therapy and other support—is that it is weak and inconclusive. (A further complication is that American child gender medicine has deviated significantly from this original protocol, in terms of length of assessments and the number and demographics of minors being treated.) Yes, as activists are keen to point out, most major American medical associations support the Dutch protocol. But consensus is not the same as evidence. And that consensus is politically influenced.
There’s an article at the site of Our Duty that discusses the shortcomings of the Dutch protocol, and is accompanied by a video of Dr. Patrick Hunter testifying before the Florida Board of Medicine; it’s a summary of the flaws of that protocol, which was applied to children much younger than 18. Here’s the video, which is short (9 minutes):
2.) Demoniziong those who question “affirmative care”.
There’s Strangio, of course, who tweeted this (and later removed it):
And this:
Marci Bowers, the former head of the World Professional Association for Transgender Health (WPATH), the most prominent organization for gender-medicine providers, has likened skepticism of child gender medicine to Holocaust denial. “There are not two sides to this issue,” she once said, according to a recent episode of The Protocol, a New York Times podcast.
Boasting about your unwillingness to listen to your opponents probably plays well in some crowds. But it left Strangio badly exposed in front of the Supreme Court, where it became clear that the conservative justices had read the most convincing critiques of hormones and blockers—and had some questions as a result.
. . .Trans-rights activists like to accuse skeptics of youth gender medicine—and publications that dare to report their views—of fomenting a “moral panic.” But the movement has spent the past decade telling gender-nonconforming children that anyone who tries to restrict access to puberty blockers and hormones is, effectively, trying to kill them. This was false, as Strangio’s answer tacitly conceded. It was also irresponsible.
Questioning affirmative care has been something that marks you as “transphobic” (I myself have been called that), but when all the facts are in, I suspect that this demonization of people who want to know the scientific and medical truth will be seen as oppressive and, given its medical results, even barbaric. As Lewis notes, the British Cass Review that resulted in closing all but one gender clinic in the UK has been falsely demonized as being discredited. It has not been discredited.
3.) Withholdiong research that doesn’t support “affirmative care”.
This is the other side of the Dutch Study coin. First you promulgate bad research that supports your side, then you are slow to publish better studies that do not support your side. The author notes that WPATH comissioned reviews of the flawed Dutch protocols and, apparently because the protocols were weak, tried to block their publication.
And then there’s the infamous study by Dr. Johanna Olson-Kennedy on the effect of puberty blockers on mental health (remember, blockers were touted as essential to prevent depression and suicide in children with gender dysphoria). Olson-Kennedy, a big proponent of affirmative care, didn’t find what she hoped for, and so withheld the study for several years!
The Alabama disclosures are not the only example of this reluctance to acknowledge contrary evidence. Last year, Olson-Kennedy said that she had not published her own broad study on mental-health outcomes for youth with gender dysphoria, because she worried about its results being “weaponized.” That raised suspicions that she had found only sketchy evidence to support the treatments that she has been prescribing—and publicly advocating for—over many years.
Last month, her study finally appeared as a preprint, a form of scientific publication where the evidence has not yet been peer-reviewed or finalized. Its participants “demonstrated no significant changes in reported anxious/depressed, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, aggressive behavior, internalizing problems or externalizing problems” in the two years after starting puberty blockers. (I have requested comment from Olson-Kennedy via Children’s Hospital Los Angeles but have not yet heard back.)
And note, this is in an unreviewed preprint.
Withholding evidence that doesn’t support your favored hypothesis is scientifically unethical, somewhat akin to falsifying data. That’s because doing this means you’re simply allowing false conclusions to persist when you have evidence for their falsity. And that means that medical practice based on those false conclusions also persists, and, in this case, children were being treated on the basis of untested ideas.
There’s a lot more in this article to chew on, but the important thing is that it was published in a reputable (and left-leaning) magazine. The NYT has had similar articles about the weak evidence for “gender affirming care.” (In my view, Pamela Paul’s 2024 critique of this care in the NYT was a big factor in her being let go by the paper. They thus lost one of their best heterodox writers.)
To paraphrase Walter Cronkite, an advocate of gender-affirming care might say, “When we’ve lost The Atlantic and the New York Times, we’ve lost America.”
I don’t oppose the use of hormones or blockers when the decision to use them is made by adolescents with sufficient mental maturity. If you’re 18 and want to change, well, go ahead and take the hormones and cut off pieces of your top or bottom. But not in minors—not until we have evidence that that this practice actually helps them—and we don’t. Lewis closes her piece this way:
Some advocates for the Dutch protocol, as it’s applied in the United States, have staked their entire career and reputation on its safety and effectiveness. They have strong incentives not to concede the weakness of the evidence. In 2023, the advocacy group GLAAD drove a truck around the offices of The New York Times to declare that the “science is settled.” Doctors such as Olson-Kennedy and activists such as Strangio are unlikely to revise their opinions.
For everyone else, however, the choice is still open. We can support civil-rights protections for transgender people without having to endorse an experimental and unproven set of medical treatments—or having to repeat emotionally manipulative and now discredited claims about suicide.
Parsimony – and when better explanations exist :
From Paralysis to Fatigue – A History of Psychosomatic Illness in the Modern Era
Edward Shorter
The Free Press / MacMillan Inc.
1992
Gender in Mystical and Occult Thought – Behmenism and its Development in England
B. J. Gibbons
Cambridge U. Press
1996
Mass-formation psychosis / psychogenic illness is more likely and already is well-known than cherry-picking some sort of new theory to support with a data fishing expedition – or a permanent FAFO experience with an enormous sunk cost to go with it.
I liked Shorter’s book, but have been amazed at the pushback against it from the chronic fatigue/”myalgic encephalitis” crowd. It is an excellent read.
For me, the stumbling block is that we are letting kids that we do not allow to use a tanning bed, or to get a tattoo, or to vote, to choose permanent sterility, the inability to have sex, to experience orgasm, to mutilate their bodies in irreversible way, and to take hormones with predictable dangerous side-effects, whilst willfully ignoring any co-existing psychiatric issues they may be having. I don’t blame the kids when all that goes wrong, I blame the adults who should know better.
Very clear contrasts – I think it shows how it is a case of the material world being reworked to fit a pet theory.
Also known as praxis – of the sociognostic-Hermetic type.
Mia Hughes cites Prof. Shorter’s brilliant book in her 2024 video at Stanford posted by Mike under 4., below.
Bought it years ago on your suggestion – essential!
Thank you for publicizing these stories, Jerry. You are doing a tremendous service to humanity, and to truth.
“But consensus is not the same as evidence. And that consensus is politically influenced.”
Good. Let me know when they do this for the anthropocentric climate change hysteria.
It’s “anthropogenic”. And it’s science not hysteria.
Yes, nothing anthropocentric about climate change. It will affect many other species far more than ourselves. H sapiens will almost certainly survive – other species won’t be so lucky.
Its freezing here right now and I live in a subtropical area. The coldest start to southern hemisphere winter in decades they say. My take – and that of other scientists I know – is that the doomsday predictions about extra CO2 have been grossly exaggerated. There were predictions for example that the North Pole would be ice-free by 2012, and from 2008 that eastern Australia would soon run out of water because there would no longer be enough rain to fill the reservoirs (the problem has turned out to be too much rain, not too little). So although I don’t doubt the greenhouse effect of extra CO2, I don’t lose sleep over it.
I’m seeing a very different climate here in Victoria, BC to what I knew decades ago (I’m over 70). Summers are somewhat warmer but winters are not just warmer but drier. Snow is now rare. The dryness is really noticeable.
Around my current house in Scotland, where I have lived for 30 years, the climate has undoubtedly warmed. Quoted daily temperatures are the mean of the minimum and maximum temperatures. I want to know if the warming is caused more by an increase in the minimum.
I now regularly see nuthatches, formerly limited to about 500 km south of here. The autumn fieldfare and redwing migration is about a month later. Stoats no longer turn fully white in winter. I use less heating than formerly. Most significantly, the latest frost in spring used to occur in mid-May but is now in early April, and the earliest frost in autumn has shifted from mid-September to late November.
All these point to an increase in the minimum daily temperature. If so, and if all this is not merely local, then warming might be a net benefit, the need to adapt apart. After all, there are about an order of magnitude more direct deaths from extreme cold than from extreme heat.
Re: “there are about an order of magnitude more direct deaths from extreme cold than from extreme heat.” Really? Can you provide some references for this? I always understood the exact opposite to be the case.
Jared, see:
https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(25)00054-3/fulltext
Indeed.
One of the main reasons proponents of child transition want to allow this is that it can result in a more convincing adult appearance of the opposite sex. If they are forced to wait until they are an adult, men for example will.have the sharper, less rounded bone structure in the face, prominent Adam’s apple, etc. The amount of surgery required to look more like the opposite sex will be much greater and never enough. It is considered cruel to force them to go through puberty of a sex they don’t wish to be. The downside of this is obvious. If only there were a magic wand to determine which child is one of the tiny percentage of trans people.
I wonder when if ever the American medical associations such as the AMA. AAP, etc. which support “gender-affirming care” for youth will begin to withdraw their support.
No, they won’t. They are afraid such withdrawal would undermine the cases of their members who are defendants in malpractice lawsuits, or act as chum in the water, leading to more. Could lead to very uncomfortable cross-examinations of expert witnesses from these professional associations. Quiet quitting is the best we can expect. In states that make a criminal offence of conversion therapy (= not prescribing GAC immediately), what is the doctor supposed to do if his/her professional associations say GAC is now medically inappropriate, too?
I have heard that rationale for early adolescent transition as recently as this year from an earnest, kind and caring (female) physician speaking publicly who wants only the best for her “female” patients trapped in the “wrong” male bodies. The objection that blocking puberty at Tanner 2 before much masculinization has occurred leaves very little penile and scrotal tissue to fashion a “neovagina” with is waved away. As is the likelihood that arousal, orgasm, and fertility will be impaired permanently. It’s as if the activists know these teenagers will never find sexual partners anyway as they are attractive only to predatory men who are much older. The other debunked justification is that letting puberty progress will cause intense, even fatal, gender dysphoria in a “woman” who gets penile erections more and more frequently for a year or two before being allowed to stop them.
Your “magic wand” image is insightful. For every discredited treatment (one that causes more harm than good) there are always a few die-hards, often pioneers in the field, who insist that despite high-qualify evidence showing no benefit they, and only they, can identify patients who, “in my hands”, do well with the treatment. The magic wand often turns out to be placebo effect, expectation bias, and motivated reasoning. After all, with suicide debunked, what is wrong with the precautionary approach? “Well, so what if there exist kids who truly would be better off in some vague way if they were transitioned, but we can’t identify them without doing more harm to them and to others than we help, so we don’t do it. After all, you can still be trans in your mind if you want to. You don’t have to pass. Learn to deal with people who clock you for what you really are.”
I don’t care if anyone thinks I’m being transphobic for saying this, including the aforementioned physician and her supporters whom I disagreed with, who did. It’s not a criminal offence in Canada (yet) to be transphobic.
100% Leslie.
For more detail follow Mia Hughes’ work on moral panics and social contagions.
She had a talk with the excellent Peter Boghossian lately and she never shuts up about it. Nor should she.
The context of over a century of medical malpractice proves all this trans madness is only the latest version. Lobotomy is one most people know but there are many. (I wrote an article about social contagions years ago and read a lot about them.)
Don’t get me wrong – I’m not a “HATE MEDICINE, BIG PHARMA” crank. I dropped out of med school early but read extensively and believe nearly all of what modern medicine does is correct and helpful.
But it does have its periodic disasters and failures. As a former options trader I’ve played around with the frequency of errors in the field.
The key is discerning the difference.
Cheers Leslie.
D.A.
NYC
Mia Hughes, very good. Have a couple of her talks/interviews queued up but I want to catch up on my TWiV as well. See also my comment below: no hormones or bits chopped off until 21 (or 25?) is what I’m thinking. (bikini medicine – bah!)
Tom, I strongly recommend Mia’s talk at Stanford University:
From Hysteria to Gender Dysphoria: How Culture and Medicine Shape Mental Illness.
Classical Liberalism Seminar, Stanford University, October 24, 2024, 85 mins (presentation of length 53 mins, followed by Q & A)
To: Peter, this thread — The link — Mia Hughes Oct 24, 2024 seminar — this is excellent, rich in content & context. Still learning. Thanks!
Fear of lawsuits is probably right. It sets my teeth on edge whenever a pro-child-treatment article lists all of the medical associations that promote “affirmation”.
The more I read about these issues, and especially about the “true self” in the “wrong body” concept, the more it reminds me of the dualism found throughout history in so many cultures.
And what strikes me recently is how very much the reaction to this dualistic mismatch reminds one of reactions of old, namely, the non-corporeal is regarded as the good and true part of the mismatch, the corporeal is seen as the evil and false element, which must therefore be modified, reformed and/or flagellated. Soul good, body evil.
Pretending I’ve read nothing, know nothing and have no opinion about this, my first question, which is genuine, is: were there lines of kids crying out for, asking for, lining up for help with this problem before somebody, somewhere introduced it to them? Where’s Bryan when I need him? We keep opposite hours, but I just know he’d have an answer for that. Point being, this problem was created. I just don’t buy that all of the sudden, out of nowhere, all these kids (toddlers?) knew they were born in the “wrong bodies”. It doesn’t ring true to me. And under the category of “too much information”, I distinctly remember crying to my mom (I couldn’t have been more than 11 years old at the time) that “these” (nipples) are okay, but “What’s this fat stuff underneath”? I was deeply troubled by breasts. To this day, I’m uncomfortable with them. Just the other day, a friend of mine was here and told me how much her “boobs” had shrunk since going on whatever the name of that weight loss shot is. I immediately told her how much I’d love for “these” (my breasts) to be out of my way. I do realize how that may sound to women who’ve had breast cancer. I have two close friends who had to endure double mastectomies when they were diagnosed with breast cancer and I don’t want to temp the evil gods. Still, I’ve had an uneasy relationship with mammary glands all my life. I can’t explain that, but I can relate to the happiness the girls felt about having flat chests. If I’d been born 40 years later than I was I suppose I would be hit upon by this overly enthusiastic group of gender care specialists ready to move me into the operating room. I never wished I were a man and I wonder how many of today’s young girls who are frightened or repulsed by their sprouting breasts will be convinced by outsiders that they were meant to be male.
“It’s not a criminal offence in Canada (yet) to be transphobic.”
Unfortunately, it is.
Canada’s Bill 4 makes it illegal to “commit conversion therapy” by telling a minor that they are not the opposite sex and/or that they should not join the transgenderist cult. You can be reported, arrested, prosecuted, convicted, and sentenced for it.
This is especially dangerous for parents and for those in the medical field who might be called upon for psychological or medical care.
You read that right: a minor who has been groomed into the transgenderist cult can report a parent to the police for attempting “transphobic” “conversion therapy.” And the police will take action, because that parent will have broken the law. The last time I remember minors being encouraged by the government to report their parents to the police, it was 1930s Germany.
It is absolutely insane, and no one in Canada knows about it–except those in the medical field, for whom it is a very real danger.
In fact, this is one of the main reasons we left Canada.
It was talking to a “Trevor Project” canvasser at the 2019 Pride Parade downstairs here (and Jessie S. and Prof. Lipman’s articles) that made me start to think all is not right in this whole thing.
Canvasser made the argument that “the earlier the better” in transitioning but never mentioned how to tell.
But that was secondary to his main point which was the suicidality. Stella O’Malley and Sasha in their 100+ podcasts about this (she’s at GENSPEC and I give them Money)… that behind most (“nearly all”) parental approval for transing is the suicide threat. And I’ve seen it in real life: “Live son or dead daughter” is the MAIN moving part in most fraught parental surrender to the hormones. It is THE motivating threat.
It comes via instagram and tumblr – so we have a movement (TRAs) who actively teach disturbed, gay and/or autistic teens to threaten SUICIDE.
That is the moral situation we are looking at.
D.A.
NYC
That’s some heavy shit, David. For real!
Ah, the ‘ol “unreviewed preprint” scheme, where the preprint can still be made publicly available online to be cited over and over as a credentialed claim by ones’ camp of adherents. Besides this area, I’ve seen now several examples of this in other rumor-mill claims. It looks like a published scientific paper. But it ain’t.
I understand your concern, particularly when journalists and advocates grab “research” that neither they nor others have assessed and then simply parrot the conclusions.
But I have some questions. Do you believe the peer-review process works as intended? Does your answer change for heavily politicized fields: race, gender, sexuality, trans, climate, intelligence, nature/nurture, etc? Even when peer review works as intended, what of the replication crisis in many of the social sciences? Or the PR push and publication bias toward sensational results? Or the pursuit of certain questions and the avoidance of others? Did we lack scientific progress before the current peer review system arose? What does formal peer review and other institutional gatekeeping add when the population of interested experts is free to review a preprint and write their critiques, post them publicly (Substack, X, wherever), and not hide behind anonymity?
I understand that peer review, along with the perceived prestige of various journals and institutions, have become shortcuts around thinking. That’s not meant to be insulting. One only has so much time in a day and the relevant expertise to review no more than a sliver of what is published. It would be nice to trust a system that allows me to outsource some of my skepticism and thinking. But talk to people in the humanities and social sciences if you haven’t already done so and you might be surprised how the zealots in academia are trying to ramrod their politics into any paper they review—even when the subject matter of the paper has nothing whatsoever to do with the “critique.” Unfortunately, the medical and other sciences are no longer immune to politicized distortion. As an interested outsider, I thus no longer trust any “peer reviewed” or “professional society” endorsement that has the slightest connection to politicized topics. It is unfortunate. The ideological push, the cowardly acceptance, the consequent breakdown of free expression and social trust has become strikingly Soviet in flavor and substance.
Are we in a thaw? I’m skeptical. But given that the freeze predates the political arrival of one Donald J. Trump, we will have to look elsewhere for blame.
DOUG WROTE: “As an interested outsider, I thus no longer trust any “peer reviewed” or “professional society” endorsement that has the slightest connection to politicized topics. It is unfortunate. The ideological push, the cowardly acceptance, the consequent breakdown of free expression and social trust has become strikingly Soviet in flavor and substance.”
When a government or professional body endorse falsehoods, it destroys faith in these organizations, causing people to discount even true and useful information. It is incredibly damaging, but it happens a lot.
Here is an example in my locality:
https://nationalpost.com/opinion/michael-higgins-b-c-law-society-cant-handle-the-truth-pretends-facts-are-racism
My comment was somewhat flippant, but your reaction has brought up important considerations.
Of course peer review has never been entirely as intended, and the process is indeed vulnerable to being compromised in heavily politicized areas like you mention. So we should weigh the merits of these unpublished manuscripts on a case by case basis. In broad strokes, though, I do think we can grant more weight toward peer reviewed papers that had been published versus papers that are not peer reviewed, simply because the published manuscript has been through anonymous review. And I know this is not perfect.
I have over 100 journal articles to my name and my experience has been that what Doug describes is not limited to political issues. If a study contradicts someone’s cherished theory, the blowback can be massive. The famous case of Garcia and Koelling’s discovery of flavor aversion learning, which many journals refused to publish because it contradicted one of the tenets of classical conditioning theory, is one of many examples.
Big time. Regardless of the “hardness” of your science, it’s not immune from politics. I’m with Doug in his loss of faith in the entire peer review process. I’ve witnessed it up close. Was it ever operating freely? I don’t know.
If children with gender dysphoria are more likely to kill themselves if they can’t transition, then when transitioning became available we should have seen a huge *decrease * in the suicide rate of people under 18.
Given some of the stories of de-transitioners, and their later-adult accounts of how they felt when they were 16 to 18, there’s a case for making the age 21.
(After all, it’s a way bigger decision than drinking a beer, which Americans, rather bizarrely, delay until 21.)
Right, I was scrolling through the comments, thinking, well, 21 minimum for chopping off bits and taking hormones. I’m thinking 25, when the brain has had more time to mature.
This trans thing is utterly crazy. Postmodern subversion, working like a charm. I read and listen to as much Helen Joyce (et al. — Genspect) as I can find. I think of Helen Joyce: How Gender Ideology Breaks Law, Medicine and Society…
I like HJ’s term: bikini medicine — for chopping off bits & hormone abuse
and I see comments above that lump gender madness with truly established science (politicized –climate most frequent example, but there’s vaccines & viruses), saying “peer review, bah!” and it’s like, right, if the Dems are talking utter gibberish about men & women and the sex binary, it’s all broken — who is to believe anything?
I can’t count the number of times I’ve seen commenters at the right-leaning WSJ argue against climate change and even vaccines by saying, “scientists also think men can turn into women.”
Justice Ketanji Jackson Brown’s inability to define “woman” is another conservative favourite.
Inevitably, any age restriction has to specify a single age for all people, although maturity varies enormously. There is no doubt that kids are maturing psychologically later in recent times, likely as a result of being over-protected, not allowed to play unsupervised, not allowed to fail – the whole helicopter parent complex. This at the same time as physical maturity and puberty is gradually occurring at younger ages. Not a combination you would want to see!
If you really want to do no harm, you would have compulsory psychiatric assessments for gender dysphoria, followed by treatment of co-existing mental conditions. You would need to ensure that psychoactive drugs are not being used and that psychological maturity is reached along with a degree of economic independence. Allowing for the difference between the sexes (if I am allowed to introduce such a controversial concept!), I would suggest that no pharmacological or surgical intervention be used below 21 in females and 25 in males. That’s if you really want to do no harm. Given that we currently assume 18 year olds have all the maturity to make any decision at all, I doubt we will ever see any age limit set over 18, and we will have to accept the damage that we do as a result.
Of course, these more or less artificial cut-off lines, be they 16, 18, 21 or 25, suffer in this case from the same problem that they face in other cases, i.e. there are plenty of 15-year-olds that are more mature and capable of such decisions than plenty of 35-year-olds, but it is difficult to impossible to introduce workable, necessarily subjective criteria instead of artificial cut-offs.
In her preprint
https://www.medrxiv.org/content/10.1101/2025.05.14.25327614v1
Olson-Kennedy claims that the lack of effect of blockers on mental health may be explained by relatively good mental health among the “trans” kids in the study.
“Ninety-four youth aged 8-16 years [showed] depression symptoms, emotional health and CBCL constructs [that] did not change significantly over 24 months. At no time points were the means of depression, emotional health or CBCL constructs in a clinically concerning range [and those mental health measures were] comparable with the population of adolescents at large, which remains relatively stable over 24 months.”
But advocates routinely claim that mental health of “trans” kids is terrible (because of bigotry against them). Today in the New York Times the journalist Jason Cherkis describes his work on a mental health crisis phone line and says the work is important because “The risk of attempting suicide is even higher among L.G.B.T.Q. young people [than among other youth] because of stigma and discrimination.”
nytimes.com/2025/07/02/opinion/suicide-hotline-trans-kids.html
Suicide is assumed to be likely for “trans” callers to the hotline.
“When a call popped up on my screen from the Trevor Project line dedicated to L.G.B.T.Q.+ callers, I waited a beat and took a deep breath. I was all but guaranteed to find someone who sounded much younger than my average caller. The risk of suicide on this line was so great that our supervisors required us to ask callers whether they were having suicidal thoughts in that moment.”
If this is the case, why was it so hard for Olson-Kennedy to recruit participants to her study who were as suicidal as the poor souls calling into that 888 suicide hotline? Or are the “trans” folks calling in to that hotline really not very suicidal (like the folks in Olson-Kennedy’s study, who she claims were actually doing pretty well mental-health-wise, and thus didn’t show any mental health benefits from taking puberty blockers)?
It is really hard to make sense of this, but it does help to explain why Olson-Kennedy was not keen to put her data in a paper for others to read and criticize. She’s right to fear “weaponization” of the results, because they seem to show that puberty blockers (and cross-sex hormones which about half of her participants had also started) don’t help these poor souls. And that’s terrible because these kids are obviously hurting and need help. The genderists are not helping them.
“The risk of suicide on this line was so great that our supervisors required us to ask callers whether they were having suicidal thoughts in that moment.”
This is standard for all suicide hotlines. It has been for decades. That’s why they’re called “suicide hotlines.”
What utter dishonest horse-dookey to pretend it only applies to kids coping with the transgenderism cult.
I have one small correction: “United States v. Skrmetti” upheld a Tennessee state law, not an Alabama one.
Yes, I corrected that already. Thanks!
You can make an argument — I do — that if gender-affirming treatment is, on balance, harmful and non-beneficial enough that legislatures have taken the extraordinary step of prohibiting doctors outright from providing it under a certain age, what is the justification for permitting it to patients older that that age?
You can immediately invoke autonomy, the right of a competent adult to take hormones and cut off body parts if he wants. But not so fast. Autonomy applies only to oneself and one’s own body. Gender-affirming treatment requires the participation of physicians and other regulated health professionals such as nurses and pharmacists. If doctors are prohibited from providing this treatment to patients under 18, surely, in the absence of evidence that at 18 some switch is flipped and makes it beneficial, they ought to take the hint and stop providing it to adults, too.
The wish of a patient to have gratifying but harmful treatment doesn’t obligate a doctor to provide it. Indeed, doctors are expected by dint of their education and experience to recognize that the desired intervention is harmful and not beneficial. They should actively decline requests, even from autonomous patients, to provide such medically unnecessary treatment. If their delegated self-regulator doesn’t make this a clear expectation of the profession, then the state has as much right to prohibit them from providing the treatment to adults as it does to minors.
Doctors find themselves in a bind now, entirely of their own making. Their professional associations lobbied vigorously to achieve consensus that GAT is medically necessary. This means that a doctor who declines on ethical grounds to provide GAT can be censured for failing to provide medically necessary care, for discriminating on the basis of gender identity, and even for providing conversion therapy in advising to let Nature take its course. A legislative ban would solve this double bind. A doctor can’t be censured for not providing an illegal treatment.
This is explored further here.
https://justdad7180.substack.com/p/adults-only
(You might need to subscribe for free to read it.)
The author, a lawyer, is less keen than I am on legislative bans for adults, citing autonomy.
I would argue similarly, but in regard to (nearly) the entire cosmetic surgery branch of (pseudo-)medicine. An ethical doctor/surgeon should in my view refuse ca. 99% of such procedures.
Unfortunately, opting for surgical procedures to deal with this or that dissatisfaction is now so engrained in our culture that it is wishful thinking to plead for it to be otherwise.
Just below the 10% limit, now just above it. Replying because I think you raise an important point.
Cosmetic surgery has always struck many of us as a little dodgy but at least it doesn’t parade under the banner of medical necessity. Insurance doesn’t reimburse for it. (To the delight of the cosmetic surgeons, who can charge far more than insurance would ever want to pay.) It’s not entirely safe, either. Patients have died under anesthesia/sedation and during liposuction, sometimes by doctors who aren’t actually trained as plastic surgeons. Cosmetic surgeons admit they are appealing to vanity, or a sense of aesthetics to put a better face on it, and are not claiming to save lives or improve physical health. They don’t deliberately seek to destroy normal organ function or foreclose on later reproductive choices. To their credit, a major American association of aesthetic surgeons has called for second thoughts about gender surgery, the only medical association I’m aware of to have done so.
There is another facet to this. Surgeons have a unique ability to decline requests. If the surgeon has not trained in the particular operation sufficiently to offer it as part of his practice, such as chest masculinization surgery, he doesn’t have to do it, (obviously), even if he does other cosmetic breast surgery. “I don’t have the skill and training to do this operation. Suggest you find a surgeon who does,” is a perfectly reasonable and ethical response if said in the right tone of voice. (An Ontario plastic surgeon successfully defended a Human Rights complaint brought by a patient who thought she was entitled as a trans person to demand that just any plastic surgeon should amputate her breasts and re-sculpt her nipples. The tribunal said a surgeon is free to decide what operations he will learn to do, and can’t be faulted for not having learned to do operations for which there later turns out to be a public demand.)
To non-surgeons demurring about prescribing cross-sex hormones, though, the patient can say, “What do you mean you don’t have the skill and training? It’s just pills. Read about them and give me what I want. The gender clinic has a six-month waiting list. [This is Canada, remember.] Are you trying to do conversion therapy on me on the sly?” Regulators and Human Rights Tribunals are likely to side with the patient.
This whole field has got so ugly and corrupted I’m glad I’m retired. The career-blighting blast radius of a single activist trans person is very large, and at ground-zero sits the poor family doctor who must do what everyone else won’t.
Ah, yes, Leslie. I was going to bow out of this discussion as I’ve already commented at least twice, BUT… there were a number of things in Jerry’s post that stood out to me and the one relevant here is, “American medicine cannot be trusted to police itself”. That was, I believe, Leor Sapir speaking. No kidding! Especially when they’re either being drummed out of practice for not buying into the lies or, on the other hand, profiting madly because they are.
Perhaps I am misreading this post, but Skrmetti pertains to Tennessee, not Alabama.
Yes, I got states mixed up. It’s fixed now, thanks.
Most states require a person to be 18 years of age to get a tattoo, presumably for the reason that getting a tattoo can’t be undone (current therapies can remove parts of some tattoos, but most tattoos are effectively permanent).
People under the age of 18 don’t have the capacity to make an informed decision. We have to draw the line somewhere, and 18 seems about right.
Making a decision to permanently change your body by stopping puberty or removing body parts is a decision that an adolescent cannot make. And then if you are surrounded by society and teachers and parents who might pressure you into thinking that the problem is gender dysphoria and the solution is affirmative care, then a confused teenager might be inadvertently misled to the wrong conclusion and do something that may harm them permanently, for the rest of their lives.
Many people have forgotten what is was like to be a teenager, and they haven’t been around a teenager in a while. Teens don’t make good decisions a lot of the time, and we shouldn’t expect them to. Tattoos or changing from a boy into a girl or girl into a boy.