The United Kingdom’s National Health Service (NHS) and the global news agency Reuters are among a growing number of voices around the world raising concerns about the affirmative care approach to treating children experiencing gender dysphoria.
England’s NHS recently warned doctors not to encourage children who believe they are transgender to change their names and pronouns – finding that most of them are only going through a “phase”, according to a report in The Telegraph.[1]
“In line with this advice, the interim service specification sets out more clearly that the clinical approach in regard to pre-pubertal children will reflect evidence that in most cases gender incongruence does not persist into adolescence.”[2] According to some studies, roughly 84 per cent of children grow out of gender dysphoria.[3]
The NHS also warned that “social transition” – in-which a child wears the clothes of the opposite sex and takes on a new name – “should not be viewed as a neutral act”, as it could have “significant effects” on the child’s “psychological functioning”.[4]
It comes amid an explosion in the number of young people identifying as transgender, with a disproportionate number of them being female.
The number of children referred for transitioning treatment in the UK increased by 1,000% among males and 4,400% among females, between 2009 and 2019, according to a report in the New York Post.[5] In the United States, a Centers for Disease Control & Prevention report found the number of young people identifying as transgender had nearly doubled since 2017.[6]
While the number of children identifying as transgender has been exploding, there has also been an increase in the number of “de-transitioners” – people who regret their “transition” and have returned to identifying with their biological sex.
The NHS has announced the UK’s Tavistock gender identity clinic will be shut down following an independent review by Dr Hilary Cass which found primary and secondary care staff felt “under pressure to adopt an unquestioning affirmative approach.”[7]
According to The Telegraph, the NHS “plans to restrict the treatment of young people under the age of 18 who are questioning their gender” following the finding that most of them are going through a “phase”.
“Those plans include a ban on prescribing young people puberty blockers outside of strictly-conducted clinical trials…and the plans emphasize that there is “scarce and inconclusive evidence to support clinical decision-making.””[8]
These findings are supported by a special report filed by Reuters on October 6, 2022, titled ‘As more transgender children seek medical care, families confront many unknowns’.
The report focuses on gender-affirming care in the United States and begins by observing that while “thousands of youths are lining up for gender-affirming care…when families decide to take the medical route, they must make decisions about life-altering treatments that have little scientific evidence of their long-term safety and efficacy.”[9]
United States President Joe Biden recently told a transgender activist he doesn’t think “any state, or anybody”[10] should have the right to ban gender-affirmative care practices. However, his administration is currently spending $17 million on studies to “analyze the dangers and uncertainties”[11] of puberty blockers and hormone therapy treatment drugs being used to treat gender dysphoria in children.
According to a Fox News report, one of the studies hypothesised that puberty blockers may “disrupt puberty-signaled neural maturation in ways that can undermine mental health gains over time and impact quality of life in other ways.”[12]
The Reuters investigation noted that puberty blockers are not approved by the US Food and Drug Administration to be used for children’s gender care:
“No clinical trials have established their safety for such off-label use. The drugs’ long-term effects on fertility and sexual function remain unclear. And in 2016, the FDA ordered makers of puberty blockers to add a warning about psychiatric problems to the drugs’ label after the agency received several reports of suicidal thoughts in children who were taking them.”
These concerns have not just been raised in England and the United States. In February 2022, the French National Academy of Medicine warned that “a great medical caution must be taken in children and adolescents, given the vulnerability, particularly psychological, of this population and the many undesirable effects, and even serious complications, that some of the available therapies can cause.”[13]
The February 25th press release stated “there is no test to distinguish a “structural” gender dysphoria from transient dysphoria in adolescence”[14] and highlighted the negative side effects of puberty blockers and hormone therapy including; “impact on growth, bone fragility, risk of sterility, emotional and intellectual consequences and, for girls, symptoms reminiscent of menopause.”[15]
The Swedish National Board of Health and Welfare also updated its treatment recommendations in February after a review found “the evidence base for hormonal interventions for gender-dysphoric youth is of low quality, and…hormonal treatments may carry risks.”[16] The Swedish review noted that a growing number of people are de-transitioning.
The movement away from “unquestioning affirmative care” is in stark contrast to recommendations of The World Professional Association for Transgender Health. WPATH’s Standards of Care Version 8 draft guidelines[17] currently recommend there should be a “general assumption”[18] to treat gender dysphoria in youth with hormones and surgeries, with the desire of the patient being the “ultimate eligibility criterion”.[19]
However, under these affirmative care guidelines thousands of children are being subjected to life changing medical interventions to treat a condition the majority of them would naturally grow out of according to the evidence.
The President of the Ethics and Public Policy Center, Ryan T. Anderson, Ph.D., pointed out the Orwellian nature of “affirmative care”, in a newly released documentary Dysconnected:
“If you are a licensed medical professional and you have a girl who doesn’t feel comfortable being a girl, identifying as a girl, living as a girl and you help her feel comfortable being a girl, that’s considered “conversion”, but if you give that girl testosterone, if you perform a mastectomy on that girl, if you “convert her into a boy”, that’s considered “affirmation”, right? It’s totally Orwellian language.”[20]
Back in May, American left-wing comedian and political commentator Bill Maher offered a common-sense critique of the idea that children should be able to decide their own “gender identity” in a segment of his ‘Real Time With Bill Maher’ show entitled “New Rule: Along for the Pride”.
“Gender fluid – kids are fluid about everything. If kids knew what they wanted to be at age eight the world would be filled with cowboys and princesses. I wanted to be a pirate. Thank God nobody took me seriously and scheduled me for eye removal and peg leg surgery.”
The countries which have updated their guidelines to restrict “affirmative care” practices will decrease the number of children undergoing the equivalent of “eye removal and peg leg surgery”.
It is undeniable there has been an explosion in the number of young people experiencing gender dysphoria. The serious question now facing those on all sides of the issue is what is the best way to compassionately care for them? Around the world, a growing number of countries are realising the unquestioning affirmative care approach cannot be the answer.
We will follow up this article by examining some of the underlying causes behind the explosion in gender dysphoria and transgender identification around the world.
