GCN global briefs
Reality, accepted
Switzerland | Detransitioner Chris Brönimann, who used to be a high-profile transwoman and gender activist in Switzerland, has issued a heartfelt appeal for protection of the young. “Progress does not mean cutting away healthy organs because someone does not fit the mould,” Mr Brönimann says on X. “True progress means helping young people to find a home within their own, unharmed skin.” He says the euphemism “gender reassignment” conceals truth from the young. “But let’s be clear about this: no doctor on this earth can change a person’s sex.” “If the deeper cause [of the urge to transition] is, in truth, emotional pain, one sacrifices a healthy body for an illusion, the consequences of which one can never shake off.”
Watch this space
United States | The midterm repudiation of US President Donald Trump should not be interpreted as an endorsement of the Democratic Party’s extreme trans rights agenda, according to Charles Lane writing for The Free Press. In parallel with the midterms, a series of referendums adverse to gender ideology passed, some in Democratic states. “Conservative activists in Colorado gathered enough signatures to put two proposed laws on the ballot, one on youth and college sports, and another on transition surgeries,” Mr Lane writes. “Each passed by a 52–48 margin at the same time that Democratic gubernatorial candidate Phil Weiser was rolling to victory with 61 percent of the vote and Democrats were capturing six of the state’s eight US House seats.”
Meanwhile, in the former Republican stronghold of Texas, House Democrat Donna Howard pre-filed a pro-abortion bill which also seeks to repeal the state ban on paediatric medical transition, journalist Gerald Posner reports. He says the repeal won’t pass the Republican Senate. “But the governor-elect [Gina Hinojosa] said this wasn’t her priority, it’s a messaging move. Her own House caucus just told voters that reinstating pediatric gender hormones and surgery is an early priority for Texas Democrats,” Mr Posner says.
Hubris
The Netherlands | Dutch gender clinics appear to regard themselves as above the law, according to medical specialist Hanneke Kouwenberg. In an article for the magazine OpinieZ, Dr Kouwenberg notes that the Amsterdam UMC and Radboudumc clinics pulled out of a meeting with MPs at the last minute. “The Standing Committee on Health, Welfare and Sport had planned a round-table discussion with various gender clinics, at which, for the first time, concerned parents of children who identify as trans would also be able to tell their stories,” Kouwenberg writes. “Any organisation that operates transparently and is funded by public money should be able to answer a few questions in the House of Representatives … Unfortunately, the gender clinics in the Netherlands seem to be above the law.”
A regrettable study
United States | A follow-up study of young patients put on cross-sex hormones at a Texas gender clinic has been hailed as a vindication of paediatric medical transition. Of 372 former patients, 360 (96.8 per cent) declared hormones to be the right decision. The limitations section of the paper, published in the prestigious journal JAMA Pediatrics, is silent on the sizeable number of patients lost to follow-up. Of the 698 surveys sent out, the researchers received no response from 297 (42.5 per cent) former patients. This relevant fact has to be gleaned from a “Participant flow diagram”, which concedes that the “hormone therapy status” for the no-response group is “unknown”. Might this group be less happy about transition? A 2021 survey of 100 detransitioners found that only 24 went back to tell their clinics they had ceased to take hormones.
As for the Texas study, it achieved its effect. “Most transgender people have no regrets years after hormone therapy, study says” was the misleading headline in The Washington Post. The study’s political purpose was explicit. The reason to do the research, the authors said, was that, “Concerns about regret and harm have led to restrictions on transgender and gender-diverse youths’ access to testosterone or estrogen therapy (i.e., hormone therapy [HT]), while empirical data on decisional regret among those initiating HT as youth remain limited.”
And their conclusion? “[T]he results provide further support for the existing standards of care, do not support efforts to categorically restrict or ban access to HT for [trans and gender-diverse] youth, and caution against making assumptions about treatment satisfaction, regret, or harm based on demographic or clinical characteristics.”
Knee jerkers
International | UK neuropsychologist Sallie Baxendale has examined hostile responses to the Cass Review’s 2024 report as a case study in cognitive bias. In the Journal of Controversial Ideas, Professor Baxendale writes: “Inaccurate claims circulated on social media within minutes of the Cass Review being published, including that Cass had excluded all the positive studies or demanded double-blind randomised controlled trials as the only acceptable evidence of efficacy. Whilst few would rely on social media for a nuanced critique of any topic, some of these inaccuracies were nevertheless repeated in some professional commentaries which then began to reference each other.”
Trans backfire
Italy | The last-minute cancellation of an Italian conference featuring journalist Alessandra Arachi, author of a new book Trans Children: Small Bodies, Big Lies, has somewhat backfired with a blaze of publicity covering her treatment, her investigative work and academic freedom. The conference, “Gender dysphoria in minors: scientific evidence, care choices and rights”—with a focus on the risks of puberty blockers—was scheduled for October 15 at the Academy of Sciences in Bologna. Other speakers were to include psychology scholar Professor Marco Del Giudice, author of an expert report to a parliamentary committee calling for prudent restrictions on the gender medicalisation of minors. Professor Del Giudice, from the University of Trieste, has deplored the “real ideological taboos” inimical to research in youth gender dysphoria.
Ahead of the Bologna conference there were student protests chanting slogans such as “Transphobes out of the university” and “Trans rage”. Shortly before the event, it was cancelled, with the Academy first citing the protests and then the absence of a competing point of view at the conference. Ms Arachi said she had spent weeks trying to find a speaker to put the gender-affirmative view; it is common for advocates of that worldview to refuse to debate any critics. After her cancellation she and her book garnered media publicity with coverage in outlets such as the TV channel Rete 4, and several newspapers including Libero Quotidiano, La Verità, La Repubblica Bologna, and the Bologna edition of the Corriere della Sera, which is her employer.
“The cancellation has therefore ended up giving her work considerably more public visibility, bringing a debate that might otherwise have remained confined to an academic audience into the national spotlight,” a member of the Italian parents’ group GenerAzioneD told GCN. “Alessandra Arachi’s book is very important because it reaffirms the essential value of scientific pluralism and the importance of providing accurate information to parents and patients.”
Ms Arachi explains that her book examines the misleading promotion by gender clinicians of the puberty blocker drug Triptorelin—“the same one used for the chemical castration of rapists”.
She told GCN her “investigation shows that the application to authorise this drug for children is not consistent with what the drug actually does. Namely: preventing the penis and breasts from developing, and stopping menstruation in girls who have just reached puberty ... [There is] a chain of lies that deceives children and, above all, parents: they are told that if this drug is not given, their children will kill themselves.”
As for the cancellation, Ms Arachi says, “What happened in Bologna was truly awful.”
“The cancellation of the event certainly generated publicity but, above all, it prevented participants—who had travelled from outside Bologna and paid for trains, hotels and flights—from attending,” she says. “The event was, in fact, cancelled 24 hours beforehand, despite having been organised a month earlier. The president of the Bologna Academy of Sciences, Giuseppe Sassatelli, bears a great deal of moral responsibility for the cancellation of the conference, as well as practical responsibility towards the registered participants.” GCN sought comment from Professor Sassatelli and his Academy.
Antonio Polito, a journalistic colleague of Ms Arachi and a former politician, has highlighted the trans activist tactic of refusing to engage with contrary views, then complaining about one-sided debate. “It seems like a ‘Catch-22’: to prevent discussion on an issue, all you have to do is refuse to participate,” Mr Polito writes in the weekly magazine of the Corriere della Sera. He insists that the use of puberty blocker drugs cannot be a taboo topic. “Since this medication is currently dispensed in public hospitals (in selected cases and following a diagnosis) and is reimbursed by AIFA [the Italian Medicines Agency], you will agree that an informed and as broad as possible debate on the ethicality of this practice appears not only legitimate but necessary.”
Word police
Australia | Gary Geelhoed, a retired paediatrician and former chief medical officer of Western Australia, has been chided by a regulator for referring to double mastectomies in minors as “mutilating surgery”. Although a complaint against Dr Geelhoed was dismissed, the Australian Health Practitioner Regulation Agency said, “We note that describing surgery as ‘mutilating’ is likely to cause offence and encourage you to carefully consider your language in future to avoid causing offence and potential complaints.”
In January this year The Australian newspaper revealed that the Perth Children’s Hospital was enabling double mastectomies for its teenage female patients who identify as boys. Dr Geelhoed’s reaction, reported by the newspaper, was: “Children can’t vote, they can’t drive a car, they can’t fight for their country, they can’t do all these things, and yet they’re allowed to consent to lifelong medications and mutilating surgery. It is just wrong, really.”
Goalposts, shifted
International | The argument that paediatric medical transition may be justified not by improved health outcomes but by the subjective wishes of adolescents has been trenchantly criticised. This novel argument appeared in a 2024 paper with authors including gender clinician Dr Annelou de Vries, who helped fashion the puberty blocker-driven Dutch Protocol. In their paper, Dr de Vries and her co-authors all but acknowledge the poor outcomes of gender-affirming medical treatment and suggest a shift of focus to satisfying teenage wishes such as “embodiment goals”.
The counterview, with German psychiatrist Florian Zepf as lead author, highlights “grave concerns” about this new subjective approach muffling the signal of treatment regret.
“Demonstrated improvement in terms of physical and mental health is a core criterion for any therapeutic treatment modality to count as evidence-based,” Professor Zepf and colleagues write. They argue that abandoning the goal of improvement after treatment is at odds with “the professional ethos of caring for the health and well-being of adolescents altogether”.
“Affected vulnerable minors deserve better than to see the goalposts for ‘effective’ treatments moved post-hoc. The use of ethics as a rhetorical refuge will neither improve knowledge nor clinical outcomes.” Professor Zepf and co-authors argue for non-medical interventions as the first line response to youth gender distress.
Another, more recent paper from Dr de Vries and her Amsterdam colleagues introduces “the fiction of prior knowledge”. They seek to re-engineer the concept of informed consent. They argue that adolescents do not get the understanding required for consent until after medical intervention. Or, as the authors put it, a teen’s “(embodied) understanding of gender-affirming treatment was mostly established through medical transition itself”.
That inversion of medical ethics has also attracted strong criticism, this time from Johan Bolhuis, an affiliated professor at the University of Cambridge and professor emeritus of cognitive neurobiology at Utrecht University. Writing for OpinieZ, Professor Bolhuis reads Dr de Vries and colleagues as suggesting that patients do not enter the clinic aware of their gender dysphoria and its possible treatment, but rather learn to become patients as gender dysphoria arises in the course of treatment. “It is therefore not surprising that more than 80 per cent of adolescents who registered at the Amsterdam gender clinic between 2009 and 2019 went on to undergo medical transition,” Professor Bolhuis writes. He sees signs of a “strategic retreat” in recent papers from Dr de Vries and colleagues. “In that light, publication in a medical-legal journal is telling,” Professor Bolhuis writes. “Medical intervention in healthy bodies without informed consent is defended by arguing that this is not possible in the case of gender dysphoria. Add to this, as the authors do, the fact that gender dysphoria is caused by the treatment itself, plus the growing international criticism, and the end of the Dutch Protocol seems near.”
Springing leaks: In sync with the “Dutch leaks” project, Genspect founder Dr Stella O’Malley talks to psychologist Dr Marieke den Ouden about the shaky, sometimes fatal, foundation of the Dutch Protocol for transitioning minors
Love bombing
United Kingdom | Former UK paediatrician Dr Hilary Cass, who led the eponymous gender dysphoria review, has called for the National Lottery to cut funding for a website, The Love Tank, which helps children get around a puberty blocker ban.
Dr Cass has also stated that the new post-Tavistock gender services—based so far in five specialist children’s hospitals—will make an attempt to track those minors who are not given hormones. During debate in the UK House of Lords in October, Baroness Cass said, “We are following up all those children who do not get any medical pathway—or as many as will agree to consent—because one of the things I could not find out during my review, as they did not have the data, is what happened to the children and young people who did not go on a hormone pathway.”
She was responding to Baroness Deech who urged a follow-up of the Tavistock clinic’s former patients, instead of the current clinical trial of puberty blockers. “The Gender Recognition (Disclosure of Information) (England) Order came into force in March,” Baroness Deech said. “It will allow the disclosure of formerly protected information and facilitate a retrospective observational study tracking the health outcomes of roughly 9,000 adults who were referred, as children, to the former Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust.”
Detrans visibility
Chile | A former trans rights activist, Nicolás Raveau, has published a report “Detransition in Chile: four testimonies in the context of the debate on the gender-affirming model”. Mr Raveau, himself a detransitioner, highlights the paucity of data on detransition, desistance and abandonment of trans identity. He writes: “The only official figure reported in Chile regarding people who have ‘stopped transitioning’ or ‘halted their transition’ relates to the year 2021 and stands at 9.9 per cent (4 out of 44 adolescents under continuous assessment for more than six months, the period specified by the DSM-5 for diagnosing ‘gender dysphoria’) at the Transiting Unit of the Dr José Horwitz Barak Psychiatric Institute, according to psychologist Josefina Cáceres.”
In one case study presented by Mr Raveau, Juan, the father of Andrea, explains how fandom led his daughter to a cross-sex identity. “She met a young woman from Spain who initially pretended to be a man; just imagine—my eldest daughter was 11 and the other was 14.” Andrea styled herself Jonathan Davis, lead singer of Korn, while the Spanish girl played the role of the band’s drummer.
“Next, this girl started telling Andrea that she fancied her and asked if she wanted to be her partner, but she had to confess that she wasn’t a man either, but a woman,” Juan says. “What happened next was that this girl began sexually grooming my daughter: she sent her pornographic drawings, manipulated her, and that’s when Andrea started feeling confused about whether or not she was trans, coupled with suicidal thoughts.
“On top of this, her grandfather was watching very explicit pornography and would lend her his computer without clearing the browsing history. All of that combined in a toxic mix … My daughter explained this pattern to me—one that is actually so common nowadays—where she began to develop an aversion to being a female subject in matters of sexuality and took refuge in virtual homosexuality to feel protected.
“Last year, our relationship was hell. Andrea was aggressive and defiant; now that she’s calmer, she’s been telling me what happened. The year before last, she told the school that she was trans, that she was having suicidal thoughts, and that neither I nor her mum were supporting her. Her mum (we’re separated) had a complaint procedure initiated against her for rights violations.”
At one point, Andrea’s father showed her confronting photos of phalloplasty and the effect on the forearm where flesh is harvested to create a pseudo-penis. In time, the girl went to live with her mother, away from the grandfather, and with the privacy of her own bedroom. Andrea learned to face loneliness and reestablished trust with her father.
“She tells me now that she’s able to look back and is calmer, she realises she should never have stopped trusting me or telling me things,” Juan says. “I think that’s very important: we had a very close relationship that was disrupted by contact with this third party who draws the child in and becomes a figure of attachment and identity formation. It’s an incredibly intense phase; children enter adolescence and rebel against conventions and the family, which is natural.
“But deep down, our culture has allowed these trans-identity behavioural models to take hold, which lead to this family breakdown. It’s not as if you went to a gig one day as a kid, got high and then sobered up, or that you suddenly grew a mohawk overnight … The natural rebelliousness of adolescents, placed within this context of manipulation, tells them: ‘Your family never understood that you were a man; you’ve always been a man, and the best thing is that you didn’t even realise it.’ And this happens at the age of 11, when they’re only just beginning to develop complex reflective skills.”
Clinics of fear
New Zealand | The voluntary status of decisions to go ahead with puberty blockers is “compromised” when those decisions are “shaped by fear”, according to Isobel Ross, a retired anaesthetist with expertise in bioethics, especially on informed consent. In a Viewpoint article for the New Zealand Medical Journal, Dr Ross writes: “Messaging that suggests a lack of access to puberty blockers increases suicide risk places parents (and patients) under coercive moral pressure.”
She cites a 2024 study analysing Finland’s comprehensive health registers with the result that suicide risk in gender clinic caseloads appeared to be driven not by lack of access to hormonal and surgical interventions but by psychiatric co-morbidities. “While distress and suicidality must always be taken seriously,” Dr Ross writes, “proportional and accurate communication is ethically vital. When fear overwhelms evidence, consent is invalidated.”
In her paper, she argues for caution in the field of youth gender distress. “The principle of ‘least invasive first’ is a recognised ethical norm in paediatrics. Where benefit is uncertain and harms may be serious or irreversible, staged care is required. Currently, evidence for mental health benefit from exploratory psychotherapy is, like the evidence for puberty blockers, very low certainty.
“However, the characterisation of exploratory psychotherapy as ‘conversion therapy’ by some proponents of the affirmation model is ethically significant, as it is likely to constrain clinical practice and, as a consequence, clinical research. Concerns about legal or professional risk may deter clinicians from using open-ended approaches that would be otherwise standard in psychotherapy, thereby limiting therapeutic options for young people and contributing to gaps in the evidence base. Unlike puberty blockade, psychotherapy is non-invasive, avoids irreversible harm and preserves future options, and, in my view, should therefore be prioritised.”
Skin-deep medicine
France | In an editorial comment, French neuropsychiatrist Paul Denis writes: “The considerable progress represented by the recognition of children’s rights tends to obscure the fact that children are not in a position to exercise their rights directly, and that the most fundamental of these is their right to protection— their right to safety—which entails limitations on their own wishes. The capacity for ‘discernment’ develops only gradually.” Dr Denis’s editorial reflects on the October 16 colloquium “The Child: Target of Ideologies”, held in Paris by the watchdog group the Observatory of the Little Mermaid.
“A teenage girl tormented by anxiety about sexuality—whether she fears heterosexuality or homosexuality—is now confronted with two complementary suggestions: one stemming from social influences, such as friends, school and activist social media, and the other from the medical and surgical options available, which include surgical castration, chemical castration through puberty blockers, and ‘cross-sex’ hormone therapy.
“The role of medical and surgical services for sex reassignment is significant. Puberty is not a disease whose course needs to be halted. The ‘Dutch protocol’ was recommended without any prior biological research or animal testing. This practice is medical in name only.”
The captured psyche
United Kingdom | Journalist Julie Bindel, who spoke to dozens of psychologists for her article in UnHerd, has painted a bleak picture of the psychological profession at a time of deep and wide influence by gender-affirming ideology. She reports that two years after the Cass Report, psychologists “attest that, if anything, things have got worse”.
“Underlying complex presentations remain unexplored and insufficient time is given to evaluate psychological needs. As the [UK] conversion practices bill strides ever closer to legislation, fear within the profession is growing—yet hardly anyone dares to speak out.1 Of that small but significant minority of child clinical psychologists who have questioned the affirmative approach of ‘gender medicine’— all have been roundly punished. Some have lost their income, been labeled transphobic, or worse, held responsible for the deaths of ‘trans kids’.”
Undercover
United States | US journalist Christina Buttons, posing as the mother of an 11-year-old “non-binary” daughter, has exposed a well-financed system to work around Republican states which have restricted hormonal and surgical interventions for minors. One “care navigator” with the non-profit organisation Campaign for Southern Equality (CSE) assured her it was “exactly correct” to view puberty blockers as a pause on development affording the child more time to decide.
In City Journal Ms Buttons reports that in 2023, CSE launched the Trans Youth Emergency Project, which has since expanded operations to all 27 states with restrictions on medical gender transition for minors, working with more than 130 local and regional partners throughout the US.
“The project connects families with co-operating medical providers, helps pay for appointments at some of those clinics, and has distributed more than $1 million in travel grants to over 1,200 families. But the effort is not limited to helping families travel to states where these interventions remain legal ... many of CSE’s recommended medical providers—with the organization’s knowledge—described ways to circumvent state restrictions and allow minors to continue receiving medical interventions in their home states.”
Too brief
New Zealand | The release of NZ government briefing documents suggests that the Ministry of Health never supported the intention of successive ministers Shane Reti and Simeon Brown to regulate the use of puberty blockers, according to Genspect NZ’s spokesperson Jan Rivers. She contends that inadequate briefing material formed the context for a narrow review of the evidence for puberty blockers and the High Court’s quashing of government regulations restricting puberty blockers.
Ms Rivers suggests that ministerial requests for information were defective. “Evidence looking at the closely related issues of transition to cross-sex hormones or gender-affirming surgery was explicitly out of scope.
“This lack of information provided to the Minister proved devastating in the court case as it made the available evidence [for puberty blocker restrictions] look thin and the decision unreasonable. The [briefing materials] show that the wider issues … decisive in curtailing the use of the medications in other jurisdictions were not addressed by the Ministry’s work. Issues such as the explosion in numbers and change of [patient] cohort remained unaddressed as was whether children are being put onto a lifetime medical path, the impossibility of providing informed consent and the close association between autism and cross-sex identity remained completely unaddressed.
A rare apology
Australia | Gender-affirming doctor Matthew Barber, a member of the Australian Professional Association for Trans Health, has apologised to another general practitioner Dr Vivian Praeger for comments he made about her on social media. Dr Praeger chaired a specific interest group on transgender and gender-diverse healthcare endorsed by the Royal Australian College of General Practitioners. Within that interest group there has been conflict between members insisting on a gender-affirming approach and others seeking a broader approach.
In his letter to Dr Praeger in October, Dr Barber apologised for comments on gender-affirming Facebook groups in which he had “publicly questioned your expertise and your suitability to lead the [special interest group], rather than confining my criticism to its governance”. He said he accepted a committee’s findings on the matter.