Taking Stock of a Milestone Moment in the Pediatric Gender Medicine Debate

A game-changer.

That’s the undeniable reality of a letter published last week in the Wall Street Journal by 21 clinicians and researchers from nine countries.

The authors, including some of the foremost experts in pediatric gender medicine, warn that childhood medical transition carries uncertain evidence of benefit but “the risks are significant and include sterility, lifelong dependence on medication and the anguish of regret.”

The letter directly contradicts a recent letter from Dr. Stephen Hammes, President of the Endocrine Society. Writing in response to a letter from Do No Harm, Hammes erroneously claimed that supposed mental health benefits of childhood medical transition are supported by robust evidence. The 21 experts rebuke that assertion in concluding that medical societies should “align with their recommendations with the best available evidence—rather than exaggerating the benefits and minimizing the risks.”

The new letter marks a critical milestone in the pediatric gender medicine debate for a couple of reasons. First, it provides further evidence that pediatric gender medicine is not based on consensus organically forged through open inquiry. Rather—like the Do No Harm letter that initiated this conversation notes—it is an illusion sustained through activist capture of medical societies and the suppression of dissent.

More importantly, the letter amounts to inconvertible evidence that trans activists have been lying about Europe’s reckoning with childhood medical transition. Activists recognize how politically damning it would be to acknowledge that some of the world’s most progressive countries are urging caution on pediatric gender medicine, so they claim that recent changes in Europe are simply procedural and not animated by concerns around over-treatment.

In reality, Sweden, Finland, and the U.K. have conducted systematic reviews of the safety and efficacy of pediatric gender medicine and concluded that it isn’t clear that risks exceed benefits. The Swedish review in fact concluded that the risks of puberty blockers exceeded the benefits. All three countries have restricted the use of puberty blockers to clinical research settings and the most exceptional cases of dysphoria.

Authorities in France and Ireland have also raised recent concerns about the use of puberty blockers as a treatment for childhood gender dysphoria.

The U.S. is an outlier in the extent to which the healthcare establishment professes certainty about the wisdom of pediatric gender medicine. Thanks to the courage and candor of these 21 experts, even activists will be forced to admit as much.