We at Do No Harm are devoted to combating divisive ideology in health care. To date, we’ve focused on the rise of race-based medicine, most notably Critical Race Theory and the diversity-industrial complex that endanger patients by lowering standards and demanding discrimination. Now, another destructive ideology demands our attention – so-called “gender affirming care.” The health and happiness of countless children are at stake, which is why we’re now fighting to curtail this unscientific and individually harmful practice.
Race-based medicine and “gender-affirming care” arise from the same distorted view. In both cases, patients are viewed as part of a group, instead of unique individuals with unique medical challenges, including psychological ones. In the case of race-based based medicine, minority patients are seen as victims of oppression, which leads to disparate health outcomes, instead of individuals with specific health issues and treatment needs. As for “gender-affirming care,” it holds that any child who questions his or her sex should automatically be given the benefit of the doubt, instead of first identifying and treating underlying or contributing medical problems. In both cases, medical associations are quick to demand adherence to this view, while dismissing any counter-arguments – a clear sign of elevating political ideology over individual patients.
The refusal to approach each patient on an individual basis is reason enough to oppose the movement toward “gender-affirming care.” Yet there’s another reason it deserves criticism: It ignores the impossibility for informed consent of the children who are subjected to this approach. Put simply, young children and adolescents are inappropriately being allowed to make potentially irreversible life-altering decisions.
“Gender-affirming car involves several treatment stages. First, children as young as 6 to 8 years are encouraged to change their names, their hair styles, and their dress to enable their belief that they are the opposite sex. Then, as early as 8 to 10 years, they are treated with drugs called puberty blockers to prevent the development of secondary sex characteristics that develop during puberty. As early as 13 to 15 years, they begin hormonal treatments that lead to secondary sex characteristics of their desired gender. Finally, and once again as early as 13 to 15 years old, they can receive surgical procedures like mastectomies, genital revisions, and plastic surgery.
These procedures are not cost-free. To the contrary: They can lead to altered bone development and cognitive maturation, and even infertility and the inability to engage in sexual relations. It is dangerous and destructive to let children, whose minds are still developing, make decisions at such young ages.
Then there’s the lack of scientific research – a key component to sound medical treatment. No one knows the risk/benefit ratio for these procedures. No one knows how many children decide to reaffirm their biological sex in the middle of these procedures, during which time their minds are developing and maturing. And no one knows how many of these patients ultimately regret their decisions and are left with devastating alterations in their psyches and bodies.
What we do know is this: As few as 12% of children who believe they are a different gender continue to hold that view as adults. Yet the gender-affirming care model assumes that 100% will maintain this belief, while subjecting them to invasive and often irreversible medical procedures. While these children may feel supported and even satisfied for a few months after entering even the earliest stages of the treatment, the longer-term results are unknown and unstudied, and the likelihood is that they’ll wish they had waited before pursuing such a drastic course. Overall, the lack of evidence makes informed consent on the part of children impossible to obtain.
To be clear, adults who decide to undergo “gender transition” have the right to pursue such treatments. But children do not. In holding this position, Do No Harm parallels the best medical judgments of most European countries, including Sweden, Finland, and the United Kingdom, which have abandoned the “gender-affirming care” model precisely because it endangers children. European countries have largely adopted a first step of intense psychological assessment and counseling, which makes sense. If there is an underlying condition or medical need, it should be addressed first, instead of jumping straight to life-altering treatments.
Sadly, the United States refuses to take this common-sense approach. At best, psychological assessments are a quick pro-forma step with no chance of derailing a gender transition. In fact, the American Academy of Pediatrics and transgender activists oppose any delay in providing gender-affirming care, including the cautious and thoughtful assessment of depression, eating disorders, and other underlying problems that have been found in many children seeking synthetic transition. As a result, compared to Europe, the U.S. offers treatments like puberty blockers and sex-reassignment surgeries to patients at a much younger age and with much less mental development. The U.S. is an outlier – and children are being victimized because our country puts ideology ahead of individual patients.
Do No Harm is committed to ensuring that children who believe they have Gender Identity Disorder are treated with the utmost care, caution, and concern. We are working closely with experts in Pediatrics, Psychiatry, Endocrinology and Social Sciences to assess the literature on this topic and identify the path forward, both for medical practice and government policy. Yet this much is already clear: The U.S. should follow Europe’s lead and abandon “gender-affirming care” for children, instead applying a more individualized and medically accurate approach. In the same way that Do No Harm fights for equal access to care, and against divisive race-based medicine, we will fight to protect children from the dangerous ideology of “gender-affirming care.“
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