The American Humanist Association (AHA) is among the most prominent humanist/atheist/skeptical organizations in America, but it’s been getting increasingly “progressive” (read “woke”). You may remember that in 2021 the AHA revoked its “Humanist of the Year” award given to Richard Dawkins 15 years earlier, saying this:
Regrettably, Richard Dawkins has over the past several years accumulated a history of making statements that use the guise of scientific discourse to demean marginalized groups, an approach antithetical to humanist values. His latest statement implies that the identities of transgender individuals are fraudulent, while also simultaneously attacking Black identity as one that can be assumed when convenient. His subsequent attempts at clarification are inadequate and convey neither sensitivity nor sincerity.
This is an arrant mischaracterization of Dawkins’s views, which were most famously expressed in this tweet in 2021 (note the coincidence with the year of revocation):

It didn’t matter to the AHA that Dawkins tried to explain what he meant by that tweet: it was a question intended to provoke discussion:

It didn’t matter that the Rachel Dolezal “transracial” issue is certainly worth discussing, and the first tweet above surely did not mean that Richard thinks the “identities of transgender individuals are fraudulent, while also simultaneously attacking Black identity as one that can be assumed when convenient.” That can be said only if you want to attack Dawkins to begin with or are flautning virtue at the expense of truth.
This shows two things relevant to this post: that the AHA has become overly woke, and, more relevant for today, the organization waving the banner of gender activism (here the issue of transgenderism) beyond reason, ignoring the facts. Both of these conclusions can be seen in the article below by Kavita Narayan, identified by the AHA as “a humanist writer and researcher based in LA.”.

Even though the piece is long for many people’s attention spans, I suggest you read the whole thing to check whether my assertions are correct and to see where the AHA probably stands on this issue. I assume that the AHA agrees with Narayan’s views, as she repeatedly invokes what the AHA believes to justify her conclusions, and the organization allowed her to publish the long article.
Here are some of the AHA’s assertions I’ve gleaned from the article. Bold headings are mine, Narayan’s quotes are indented, and my comments are flush left:
1.) Denying “affirmative care” to anyone (including adolescents) who wants it, with that care including hormones and surgery, is unethical.
Transmasculine and nonbinary individuals report invasive gatekeeping, as well: Jordan, 22 and nonbinary, remembers undergoing humiliating questioning before a hysterectomy consultation, a stark reflection of a system built only for cis bodies.
A humanist framework grounded in reason, equality, and bodily autonomy holds that denying care based on gender identity is not only a practical failure, but an ethical breach. “To deny someone care… is not just unethical, it’s inhuman,” says ethicist Casey Ruhl.
. . . This is where humanism can make a unique impact. Unlike traditional religions that may treat gender diversity as a moral debate, humanism begins from a different premise: that every individual has inherent worth, and that self-determination is not a privilege, but a right. “Humanism allows us to honor people without pretending to know them better than they know themselves,” says Elan, a queer humanist chaplain.
Note that they give no age limit here: any child or adolescent who claims to be of the sex different from their natal sex has a right not just to be believed, but also given affirmative care. I would add here that unless you’re “of age” (I’ll take it to be the age of 18, the legal age at which a person can make their own healthcare decisions), I would not be so quick to say that a person “knows themselves,” particularly when it comes to “knowing” that they’re really of their non-natal sex. “Self-determination” for medical issues is not a right for anyone under 18, and may not be warranted if someone wants to transition when they have other psychological issues when over age 18. Often gender dysphoria is part of a complex of other, unrelated psychological problems, problems that are often confused with gender dysphoria itself (see below). It can also be exacerbated by social pressure–the “affirmation” from peers, which is often very strong.
Finally, remember that doctors are not obligated legally to do anything that a patient wants, even if it’s harmless. If someone goes to a doctor with a viral infection and demands antibiotics, doctors are perfectly within their rights to refuse, for antibiotics are not only useless against viruses, but their wanton use can increase antibiotic resistance in bacteria. If you ask someone to cut off your arm because you think it’s superfluous (yes, there are such people), doctors can and will refuse, and will not suffer for it. And no doctor is obligated to give children or adolescents puberty blockers or hormones just because they ask for it. (A good doctor will refer such people to competent specialists.) This doesn’t mean that if someone has an easily treatable ailment or injury, it is ETHICAL for a doctor to refuse treatment, but gender transitioning does not fall into this category. It takes a specialist in pediatric gender transitioning, objective rather than affirmative therapy, and above all what we don’t have: evidence that it’s safe to use puberty blockers. After puberty is over, of course, a gender-specialist doctor can help transitioning by giving hormones and other things, though surgery is something that requires careful thought, and perhaps many surgeons won’t agree to go snipping off breasts or genitals.
2.) There is no lower age limit to begin “affirmative treatment”, and treatment that includes puberty blockers is reversible. While the article argues that gender-affirming care is safe and efficacious “when providce with informed consent”, what does that mean? If parents assent that it’s okay to inject a child or adolescent with hormones or cut off bits of their body, does that mean that a child of any age has a right to do that, so long as they find a compliant doctor? Look at the title of this section:
The Myth of “Too Young” and the Data That Debunks It
Opponents of gender-affirming care often argue that children are too young to make life-altering decisions. But this talking point misunderstands both the process and the people it affects.
Gender-affirming care for minors doesn’t begin with surgery. It starts with listening. It involves long conversations with therapists, pediatricians, and families. Puberty blockers, often the first clinical step, are fully reversible and give young people time to explore their identity without the permanent effects of endogenous puberty.
Narayan’s “myth of too young” is invidious. First, it’s not uncommon for children to be referred to doctors for affvirmative therapy or even hormones after just one or a few visits, lacking those “long conversations.”
Second, talk therapy that supports and verifies the conclusion of a young person that they are transgender should be, but is not invariably, objective. What if the therapist fails to affirm the child’s assertion, concluding that the child is too young or is caught in a morass of psychological confusion? Is that unethical?
And is “too young” really a myth? Children as young as 11 (e.g., Jazz Jennings) have taken puberty blockers, and, at 17, Jennings had the difficult and complex “bottom surgery”. Other papers report girls as young as 13 getting double mastectomies. In 2022, the organization WPATH, a villain in this narrative, recommended these things:
The World Professional Association for Transgender Health said hormones could be started at age 14, two years earlier than the group’s previous advice, and some surgeries done at age 15 or 17, a year or so earlier than previous guidance. The group acknowledged potential risks but said it is unethical and harmful to withhold early treatment.
Surgery at 15 and hormones at 14?
Note the “unethical” trope, as raised by Narayan above. As for “harmful to withhold early treatment,” it’s important to realize that the majority of adolescents and children who are not given affirmative treatment eventually come out as gay, so that neither surgery or hormone treatment needs to be done.
As I’ll mention in a minute, those treatments might damage people’s health, despite Narayan’s assertion, and we don’t know their long-term effects, except that post-puberty hormone treatment, as well as bottom surgery, can leave people without the ability to have a sex life that includes orgasms. Simply affirming a child’s self-diagnosis and giving them whatever hormones they want is bad practice without careful vetting, and certainly there are ages that are “too young” for that. (I’ve suggested a lower limit of 18, but even 21 may be okay.)
At any rate, there are a variety of studies showing the proportion of children with gender dysphoria who do not receive affirmative care and wind up deciding they’re gay. This varies from 39% to 80% among boys. Data from girls are sparser, but several studies of small samples say that untreated gender-dysphoric girls usually become lesbian or cisgender women. Given this, and the possible dangers of hormone treatment and demonstrated dangers of surgery, saying that no child is too young to be treated, and that they have a right to be treated the way they want, is, to me, both unethical and harmful. To foster the idea that there is no such thing as “too young” is pushing children to make decisions that they’re not ready to make—decisions that will change their lives and bodies forever.
As for the harm of puberty blockers when they are stopped, there is insufficient evidence about the long-term effects of puberty blockers on several traits, and some evidence that there are irreversible effects on bone density and height. As the Cass Report states:
There were no high-quality studies identified that used an appropriate study design to assess the outcomes of puberty suppression in adolescents experiencing gender dysphoria or incongruence. There is insufficient and/or inconsistent evidence about the effects of puberty suppression on gender dysphoria, mental and psychosocial health, cognitive development, cardio-metabolic risk, and fertility. There is consistent moderate-quality evidence, albeit from mainly pre-post studies, that bone density and height may be compromised during treatment.
There is a lack of high-quality research assessing the outcomes of hormones for masculinisation or feminisation in adolescents with gender dysphoria or incongruence and few studies that undertake long-term follow-up. There is little evidence regarding gender dysphoria, body satisfaction, psychosocial and cognitive outcomes, and fertility. There is moderate-quality evidence from mainly pre-post studies that hormone treatment may in the short-term improve some aspects of psychological health. There is inconsistent evidence about the effect of hormones on height/growth, bone health and cardiometabolic effects.
There is certainly not enough evidence to say that the effects of puberty blockers on the body are safe and fully reversible, although some of the phenotypic effects may be. The lack of firm evidence that blockers are irreversible and safe is one reason the puberty blockers (not approved, by the way by the FDA for blocking puberty, and always prescribed “off label”) are considered “experimental treatment” in the UK under 18, and are severely restricted in quite a few other countries like Sweden. Almost nowhere are they permitted to be given willy-nilly to children or adolescents at their request, as Narayan seems to feel.
3). Withholding affirmative care increases depression and suicidality. Affirmation is, as the article says, “life-saving”. Note that the AHA is very canny here, repeatedly using the word “suicidality” rather than “suicide”, although the general claim among gender activists is that withholding affirmative care increases suicide itself. But the American Psychological Association defines “suicidality” as “the risk of suicide, usually indicated by suicidal ideation or intent, especially as evident in the presence of a well-elaborated suicidal plan.”
The AHA says this:
Affirmation isn’t just emotional. It directly correlates with better mental health outcomes. A 2022 study in JAMA Network Open found that transgender youth who received gender-affirming care had significantly lower rates of depression and suicidality than those who did not. These effects persist into adulthood, with gender-affirming hormones and surgeries linked to improved quality of life and reduced psychological distress.
The link given doesn’t go to an article I can find, but I do know of one good study that seems to me the gold standard of the relation between gender dysphoria and suicide itself. And it shows that, when you disentangle the effects of psychiatric problems not related to gender dysphoria from the data, there is no difference in the suicide rates of adolescents without gender dysphoria compared to those either presenting for treatment for gender dysphoria or going on to gender reassignment via surgery and hormones. That is, dysphoria and its affirmative treatment doesn’t increase suicidality or suicide itself. You can find this 2024 study below, published last year in the BMJ [British Medical Journal] Mental Health; click on screenshot to read. If you’re blocked, click here to see the full text or here to get the pdf:

The study is the best because it had a large sample, lasted over 23 years into adulthood, and, moreover, was conducted in Finland, where every individual is numbered and their doctor and psychiatric visits tallied. The sample was of 2,083 adolescents who sought gender-identity assessments and/ir desired gender reassignment (GR). For each of these target individuals, EIGHT control individuals were assigned, matched by age and sex. The results were that, without multivariate analysis, there was a slight but nonsignificantly higher rate of suicide among the 2,083 “GR” (gender-referred) children, some of which went on to full transition. But that difference completely disappeared when the authors controlled for other psychiatric issues. As the paper says (my bolding):
Most importantly, when psychiatric treatment needs, sex, birth year and differences in follow-up times were accounted for, the suicide mortality of both those who proceeded and did not proceed to GR did not statistically significantly differ from that of controls. This does not support the claims that GR is necessary in order to prevent suicide. GR has also not been shown to reduce even suicidal ideation, and suicidal ideation is not equal to actual suicide risk. To the best of our knowledge, the impact of GR on suicide mortality among gender-referred adolescents has not been reported in earlier studies. In an earlier study by Dhejne et al,11 even when psychiatric morbidity was controlled for, participants diagnosed as transsexual in adulthood who had undergone both hormonal and surgical GR displayed increased suicide mortality compared with matched population controls. Nonetheless, these authors focused on patients treated before 2002. More recent cohorts, particularly adolescents, may differ from those in earlier decades, and stress related to gender identity itself may be lower presently because of decreasing prejudice.
In other words, gender-dysphoric youth who sought help but did not proceed to gender reassignment did not differ in suicidality from those who went on to gender reassignment. Further, when psychiatric difficulties were taken into account (number of visits to psychiatrists), neither of these differed in either suicidality or suicidal rates from controls. The finding that there was a difference in earlier studies may have been due to the conflating effects of psychiatric difficulties, since those seeking help for gender dysphoria, or proceeding to gender reassignment, apparently have more such difficulties (unconnected to dysphoria) than those who don’t, and psychiatric difficulties greatly increase the rate of suicide.
What all this means is that neither “suicidality” nor suicide itself differs in rate among control children lacking gender dysphoria, whether or not they go on to gender reassignment treatment. The argument for affirmative care that says, “you can have either a dead daughter or a live son” is not borne out, at least by this study. Have a look at it; I was impressed by the quality of the work, which would not be possible in countries where every individual is tracked for both medical and psychiatric care.
The AHA, then, is, to my mind, grossly distorting what we know about suicidality, affirmative care, and the risks of gender dysphoria. It is not known to be safe to give adolescents puberty blockers; there should be a lower age limit; and you are not preventing suicides by giving “affirmative care.” In this sense I consider the article misleading and irresponsible.
So many skeptical/humanist/atheist organizations lose their skepticism when it comes to gender issues! The only one I trust, because it’s published articles on gender like this and this, is the Center for Inquiry, which appears to be the only one that is strongly based on evidence.
But read for yourself, and, if you have time, do a scan of the literature, including the Cass Review.
Tomorrow I’ll publish a letter to the AHA from a disaffected member who took strong issue with the article above, and will say a few words about their response, which I won’t publish as I didn’t ask permission. Thanks to that reader for calling this article to my attention.
Let me finish by saying I have nothing against adolescents or children who feel that they are trapped in the wrong body, nor should there be discrimination (except in sports or things like jails) affecting transgender adults. I’m glad to call anybody whatever pronoun they want, and abhor those who really do dislike or denigrate trans individuals. All I ask for is rationality when it comes to treating young people, and that that treatment should always, like all medical treatment, be based on evidence.