Rarely does a single journal article capture the full range of intellectual errors committed by pediatric “gender” activists. A June 2026 “clinical perspective” in the Journal of the American Academy of Child & Adolescent Psychiatry comes very close.
A mere glance at Michal J. McDowell et al.’s “Using a Cognitive Behavioral Family Therapy Model to Join Caregivers of Transgender and Gender Expansive Youth” is enough to alert the reader that he or she is in strange territory indeed.
At the bottom of page one sits a “Diversity & Inclusion Statement” boasting that “[o]ne or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science,” a statement presumably intended to lend additional credence to the work. (We see instead the potential for bias.)
Perusing the article’s figure and table turns up references to the alleged “cognitive distortions” of “caregivers” (e.g., parents) who fail to “support” the trans-identifying youth in their charge.
The main thrust of the paper is that cognitive behavioral family therapy — “an integrative therapeutic approach that emphasizes the family as a system, in which changes in behavior or thought processes of one member can influence the entire family unit” — should be used to change the minds of recalcitrant adults who fail to “affirm their child’s identity.”
Yet underlying this assertion are the typical activist contortions and mischaracterizations of the evidence. The paper offers these in spades.
To begin with, the article misleadingly claims that “[a]ccess to gender affirming care for [transgender and gender expansive] people … including puberty blockers, gender affirming hormone therapy, and gender affirming surgeries, has been shown to provide a multitude of psychological and other benefits.”
Lined up to support this assertion are the individual studies often trotted out by “gender” activists (by Turban, Tordoff, Chen, etc.) but no systematic reviews. No wonder: Nearly two dozen systematic reviews have found no credible evidence supporting the “gender” interventions described.
The article goes on to claim that “access to desired gender affirming hormones during adolescence … has been linked to lower levels of depression and suicidal ideation later in life.” This, too, is unsupported by the myriad systematic reviews that have been undertaken.
The aforementioned Table 1 reframes ordinary parent concerns — that, e.g., the gender-dysphoric child has been influenced by the internet or by his or her peers — as erroneous thinking (“distortions”) that need to be restructured toward affirmation.
Indeed, the article advises clinicians to “guide caregivers in cognitive restructuring to replace distorted or unhelpful thought patterns,” a recommendation that brings to mind the mental-health “treatments” forced on dissidents in, say, Soviet Russia or China during the Cultural Revolution.
Among the paper’s assertions is that a common-sense awareness that a child may regret undergoing surgical or pharmacological “gender” interventions should be dismissed as mere “[f]ortune-telling” — a particularly arrogant claim given that researchers don’t know the true rate of regret among gender-dysphoric adolescents who are allowed or prompted to undergo sex-denying medical “treatments.”
The article urges caregivers to “us[e] their child’s name and pronouns consistently,” to “advocat[e] with school systems,” and to “communicat[e] with extended family members about identity affirmation,” three measures that will inevitably make it harder for the gender-dysphoric child to desist from his or her transgender identification (as historically most gender-dysphoric children naturally do).
To call these recommendations bad is grossly to understate the potential damage caused by equating supportive homes with the mandatory social and medical “transitioning” of children.
The (actual) evidence suggests that the opposite is the case.
If a child presents with gender confusion, parents should remain calm, listen carefully, and provide loving, grounded support while holding firm to biological reality.
They should remember that no child is born in the wrong body and should recognize and limit the negative influences feeding their child’s distress, among them social media, online communities, and peer groups.
Parents in such circumstances should seek help from professionals — not activists — who explore and treat the root causes of gender dysphoria as well as any co-occurring conditions (e.g., depression and anxiety) rather than defaulting to instant affirmation.
Steadiness, honesty, and competent, compassionate mental-health care give children the best chance to work through their confusion without tragically and irreversibly medicalizing their distress.
That McDowell et al.’s new paper takes exactly the opposite tack is more than a little disheartening.
But it is also a useful reminder of what we’re up against.
