Care, not coercion

UK trial ordeal; reputational damage Down Under; smears and attacks hither and yon; the Siren song of Germany's guideline; Alberta advances its ban; US bishops say No; Norway debates puberty blockers

Photo by Maria Budanova (Pristavskaya) on Unsplash

GCN in brief

A vote for parental care

Chile | The Chilean parents’ group Kairós has welcomed news that the Gender Identity Support Program (PAIG)—a government-backed gender ideology platform promoting social transition from the age of three and medical referrals from the age of nine—will not receive state funding for 2026.¹ The country’s Chamber of Deputies last week voted to confirm the Senate’s decision not to fund the PAIG. A special investigative commission of the chamber was highly critical of the PAIG, which also allowed intervention in schools, and legal action against parents who resisted the gender medicalisation of their children.

In a statement Kairós said “the biggest problem with the PAIG, in our view, has been its intrusion into the heart of our families, restricting and inhibiting our parental authority, triangulating and straining our relationship with our children, affecting the mental health of their siblings, grandparents and other relevant relationships, and, in addition to this, leading to us being harassed by state instruments and ultimately prosecuted. There should be no program with such totalitarian and coercive powers.”

“It is time to stop and significantly reformulate the support that the state should provide to our young people, focusing on their deteriorating mental health due to multiple factors, broadening our perspective and investigating in depth the reasons for this distress, which is real and evident to us as parents because we see them suffer on a daily basis.

“But the solution lies in helping them overcome these problems with therapies appropriate to their stage of development, not with simple ‘solutions’ such as a change of clothes, and even less so with complex medical interventions such as halting their pubertal development and preventing them from growing, [or giving them] hormones or surgery.”

Iatrogenic medicine

International | DNA remains of Adolf Hitler reveal he suffered from Kallmann syndrome, “a genetic disorder that hinders the normal progression of puberty and the development of sexual organs,” The Times has reported. Puberty blockers prescribed by gender clinics create a similar disease state in otherwise healthy children who reject their birth sex and fear going through a normal puberty.

Trials and tribulations

United Kingdom | An estimated 226 children under 16 will be given puberty blocker drugs as part of a two-year UK clinical trial recommended by the Cass review. The announcement that the long-delayed trial had been given ethical and regulatory approval has generated strong pushback.

Existing National Health Service patients with “gender incongruence”—a sense of mismatch between a subjective “gender identity” and the body, but not necessarily involving any distress—will be randomly assigned to two groups, with half starting puberty suppression straight away and the other half waiting for 12 months. Former Tavistock clinic whistleblower Dr David Bell said “the design is likely to produce a spurious difference between the groups who get the puberty blockers straight away and those who have to wait a year. This won’t be meaningful but will be an artefact of the design”.

Both groups will also receive psychological support. “It is unclear how this design will allow the research team to judge to what extent any observed benefits or harms are due to the medical intervention, as opposed to the other support being provided alongside,” journalist Hannah Barnes wrote in the New Statesman.

A parallel study will examine the brain development of minors receiving blockers during the NHS-backed trial as well as the cognitive state of those given non-medical treatment. It is feared that suppression of natural sex hormones during adolescence may interfere with critical windows for cognitive development, creating lifelong deficits.

Author of the book “Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children”, Barnes said the clinical trial’s “primary objective” as stated in the protocol was “to determine the short/medium-term benefits and risks” of puberty blockers.

“While this will include looking at a young person’s quality of life and mental health, as well as the ‘impact on cognition and brain development and physical effects including bone mineral density’, longer term effects of the drugs will only be studied ‘pending further funding’,” she wrote.

“But it is precisely regarding the long-term effects on neurocognitive development, psychosexual development and bone health where the gaps in the evidence base lie. It is not clear that this new NHS-funded study will fill those gaps.”

Writer Andrew Doyle had a more fundamental objection: “In order to justify this trial, which could potentially ruin many children’s lives, we should surely first establish beyond doubt that such a thing as a ‘gender identity’ exists. In spite of its confidence about the trials, our government cannot even define the term ‘gender identity’ …”

“Injecting children with a hormone-suppressing drug to investigate supernatural claims is simply not morally defensible. It will doubtless impact most severely on children who are autistic, who suffer from unrelated traumas, or who are likely to grow up gay.”

Detransitioner Keira Bell, who was given puberty blockers at the Tavistock clinic, has foreshadowed a High Court challenge to the trial, which she said was “a deeply unethical, disgusting experiment on the children of this nation”. Dr Alice Hodkinson, co-founder of Biology in Medicine, has argued that the NHS should instead track down the 2,000 children given puberty blockers at the Tavistock and evaluate the outcomes.

Gender-critical AGM

Australia | The Royal Children’s Hospital (RCH) Melbourne, which was the beachhead in Australia for the radical “gender-affirming” treatment model, faced an unexpected challenge from two mothers of gender-distressed children at its annual general meeting on Monday.

“My question to the board is, when will RCH acknowledge the reputational damage being done to the hospital through the refusal to engage openly on the contested topic of paediatric gender treatment and the criticisms of the hospital’s role in championing an increasingly discredited treatment model?” asked one mother.

In reply, RCH board chair Christine Kilpatrick cited the board’s oversight of clinical governance. “There are many elements of the treatment which are carefully thought about to make sure there is evidence for that treatment…” said Professor Kilpatrick, who was chief executive of RCH when the gender clinic began its rapid expansion in the mid-2010s.

A second mother at the AGM told the board that “the Cass review, which did review the evidence, in fact, concluded that the evidence for the gender-affirming model … is very poor … To put children on puberty blockers, [when] almost invariably they will go on to cross-sex hormones, [means] they will be sterile, they will have no sexual function—a child cannot give informed consent for that.”

Professor Kilpatrick, who trained as a neurologist, said: “I’m not a paediatrician, and I’m certainly not an expert in gender dysphoria, but I can understand that the treatment of this condition is for many people, I’m sure, challenging, and the concept of the condition is challenging”.

Go west

International | The British-founded online clinic GenderGP, based in Singapore, is chasing new business in the US, and its co-founder Dr Helen Webberley has fronted up for a flurry of media interviews. The UK ban on private prescribing of puberty blockers was crafted to stop offshore entities such as GenderGP undermining the NHS policy to end routine use of these drugs.

On X/Twitter, UK barrister Sarah Phillimore declared: “Gender GP is a dangerous outfit which puts profit over lives of children. Please do sue me if this is a lie Dr Helen. I will rely on the whole judgment in re J [2024]”.

In that English High Court case, J was a 15-year-old girl with a history of autism, self-harm and anorexia who identified as a boy and was prescribed online by GenderGP such a high dose of testosterone that she was thought to be at risk of sudden death. A comparable “loading” dose of adult testosterone is suggested as a starting dose for female adolescents in the “Australian standards of care” treatment guideline issued by RCH Melbourne, a document praised as “beautiful” by Dr Webberley.

Body and soul

America | US Catholic bishops have voted to formalise a de facto ban on Catholic hospitals offering gender medical transition procedures. “In order to respect the nature of the human person as a unity of body and soul, Catholic healthcare services must not provide or permit medical interventions, whether surgical, hormonal, or genetic, that aim not to restore but rather to alter the fundamental order of the human body in its form or function,” the updated guidelines say.

Reverse ferret

Norway | The fallback argument for puberty blockers—never mind the absence of proven mental health benefits, the treatment is a success simply because it blocks puberty—has generated lively debate in Norway’s Morgenbladet newspaper. Last month, health sciences academic Atle Fretheim criticised the UK Cass report’s finding of very weak evidence for the use of puberty blockers with gender-distressed children.

“The purpose of the treatment—i.e., to stop puberty—has been completely ignored in the debate about whether puberty blockers work,” Professor Fretheim said. “In the wake of the Cass report, it seems that the goal of treatment has been defined as reducing psychological distress. Where did that idea come from? It is difficult for me to explain why some people have chosen to focus on this outcome rather than on the original purpose of puberty blockers.”

(In fact, the mental health case for blockers goes right back to the pioneering 2011 “Dutch protocol” study, which claimed that “Behavioral and emotional problems and depressive symptoms decreased, while general functioning improved significantly during puberty suppression.” Studies in the UK and US have failed to reproduce those mental health benefits. The Cass review, and other independent systematic reviews, have discredited the much-repeated claim that blockers bring about potentially lifesaving improvement in mental health. It was never in doubt that blockers achieved the physical effect of suppressing the natural sex hormones and their associated bodily changes.)

In a letter of rebuttal to Morgenbladet, four physicians including general medicine specialist Dr Esben Buhl remarked that Professor Fretheim seemed “little concerned with general medical principles regarding risk versus benefit”. They argued that these invasive treatments of young people, many of whom would ultimately accept their bodies were it not for puberty blockers, are “simply bad medicine”.

“Treatment with puberty blockers, [cross-sex] hormones and possible surgery causes permanent changes to the body and must be considered experimental treatment due to the poor knowledge base regarding long-term effects. It is highly doubtful whether truly informed consent is possible for both parents and children, due to a lack of medical knowledge and the immature brain of young people. We risk doing great injustice to a group of vulnerable individuals whose bodies and brains are far from fully developed.”

In another contribution, the parents’ group GENID protested that “medical-ethical assessments are not only about whether a drug has the expected physiological effect”. “We must remember that puberty is a normal biological process, not a disease that requires emergency measures. Stopping it is a profound intervention in the development of the body and brain.”

HHS Redux

America | The May 2025 gender dysphoria report commissioned by the US Department of Health and Human Services has been republished with peer review reports and identification of its previously anonymous authors, among them healthcare researcher Evgenia Abbruzzese, a co-founder of the Society for Evidence-based Gender Medicine. Admiral Brian Christine, who succeeded the transgender-identified Rachel Levine as assistant secretary of the department, said the report confirmed that “sex-rejecting procedures such as puberty blockers, cross-sex hormones and surgeries for children are dangerous”.

Future choices

Canada | The province of Alberta has invoked a constitutional mechanism to enable passage of three laws to counter gender ideology, including a ban on puberty blockers and cross-sex hormones for minors under age 16. This would be the first such ban in Canada. The mechanism allows the legislature to declare that a law operates notwithstanding any inconsistency with the Alberta Bill of Rights or Human Rights Act. Centre-right Premier Danielle Smith said it was necessary to use the “notwithstanding clause” to protect the future choices of vulnerable minors, and end the delay and uncertainty of legal challenges brought by trans rights organisations.

A bill to prohibit paediatric medical transition in the centre-left province of British Columbia last month was shut down before it could be debated. The Protecting Minors from Gender Transition Act was sponsored by Legislative Assembly member Tara Armstrong from the new breakaway conservative party OneBC. The draft law would have held health practitioners liable up to 25 years after the hormonal or surgical intervention. In the assembly, Armstrong said the province was “sleepwalking through the greatest medical scandal in modern history”. Her motion that the bill be introduced and read a first time was defeated 48-40.

Meanwhile, the 2023 gender-affirming position statement of the Canadian Paediatric Society has been criticised for multiple shortcomings. In a letter published by the Archives of Sexual Behavior, psychologist Chan Kulatunga Moruzi and her colleagues argue that the paediatric society position paper made claims about puberty blockers “that are not supported by evidence, overstated their benefits, and understated their risks”.

Guidance, please

Norway | In Norway, gender-affirming treatment guidelines remain in place, despite the country’s Healthcare Investigation Board issuing a report in 2023 advising a review and recommending that puberty blockers, cross-sex hormones and surgery for gender-distressed youth be defined as “experimental treatment”. In the newspaper Aftenposten, Mikael Scott Bjerkeli of the Harry Benjamin Resource Centre earlier this month said the 2020 guidelines “provide no specific guidance on how practitioners should actually approach patients clinically. They refer to rights and general principles, but say little about how assessment, evaluation and follow-up should be carried out in practice”.

He took issue with suggestions that Germany’s 2025 gender-affirming guidelines be a model for Norway, pointing out that leading health professionals, such as Munich psychiatrist Dr Alexander Korte, and some organisations withdrew from the German guideline project in protest. “They felt that the process did not take into account the lack of evidence and that the principle of psychological assessment was weakened,” Bjerkeli said.

“The document that was ultimately adopted is a so-called S2k document, i.e., a consensus document, not a systematic knowledge-based guideline. The scientific quality is therefore not at the level otherwise required for medical practice.”

Think again

Australia | Australia’s federal Health Minister Mark Butler has been urged to abandon a flawed attempt to draft new clinical practice guidelines for youth gender dysphoria and instead establish a full inquiry or royal commission into current treatment practices. An open letter to Butler, signed by Dr Louise Kirby on behalf of the Australian Medical Professional Society, argues that the new guideline project assigned to the National Health and Medical Research Council by the minister has had its impartiality compromised by the involvement of figures linked to current clinical practice. The November 26 letter to Butler contends that “gender-affirming care” is not medical treatment.

“Clinicians are effectively providing whatever ‘products’ are requested by the consumer rather than performing true assessment, diagnosis, and informed consent. The result is iatrogenic harm, including sterilisation of healthy young bodies and diminished sexual function”.

The open letter recommends that Australia adopt the more cautious treatment policy set out by the UK Cass review. This course of action also has the support of the Australian Doctors’ Federation and the Nurses’ Professional Association of Australia. (The three health professional organisations associated with the open letter to the minister are small in membership, whereas Australia’s large organisations in the health sector appear captured by gender ideology.)

America | Two-thirds of doctors support Florida’s ban on the gender medicalisation of minors, according to a new survey. The 736 Floridian physicians who completed the survey included 37 per cent registered Democrats and 23 per cent unaffiliated; the rest were Republican voters. US medical organisations typically support identity politics causes such as gender-affirming care, creating the appearance of consensus. But they are out of step with rank-and-file doctors and the general public, according to the Florida survey report from the group Do No Harm, which says the results are “a clear call to re-center medicine around common sense and sound science”.

Fourth estate

France | Journalistic scrutiny of trans activist bias in French health policymaking has been vindicated with the dismissal of a privacy complaint against the newspaper Figaro. In June 2023, Figaro reported that most of the experts chosen by the French National Authority (HAS) to draft a new treatment guideline were trans activists and many were themselves trans-identified. One member of the HAS working group filed a complaint alleging violation of a private trans identity. That complaint has been dismissed with costs, according to Paul Sugy, the journalist who wrote Figaro’s scoop.

Cancel culture

United Kingdom | Counsellor Christian Buckland says trans activist pressure forced him out as chairman of the UK Council of Psychotherapy after he expressed concerns about the safety of the gender-affirming treatment model for children. “He claims to have been sent death threats by independent activists including a hand-written ‘rest in peace’ sign as part of an intimidation campaign,” The Daily Telegraph reported last month. The backlash began when Dr Buckland withdrew the council he led from an activist-influenced memorandum of understanding on conversion therapy. One email to the council included the phrases “Your time will come” and “transphobic Nazi cunt”.

Data that identifies as true

International | A survey of trans activists, published in the journal Big Data & Society, reported that “actionable and useful data for community care was the utmost priority over true, accurate, or verifiable data”. The journal article’s title? “Trans data epistemologies: Transgender ways of knowing with data.”

Keeping doctors in the dark

America | The Society for Evidence-based Gender Medicine (SEGM) announced last month a new suite of continuing medical education courses to offer “comprehensive guidance on the benefits, risks, and ethical considerations of medical interventions for gender-dysphoric youth”.

One course, titled “Misconceptions in youth gender medicine”, surveys the evidence for key assumptions of the gender-affirming treatment model, including the safety and reversibility of puberty blockers and the lack of ethical alternatives to medical transition. SEGM had organised to offer these courses free of charge with Washington State University (WSU) as joint provider.

Trans activist journalists, recycling the Southern Poverty Law Centre’s smearing of SEGM as an “anti-LGBTQ+ hate group”, denounced the arrangement, triggering an investigation by the accrediting authority and a suspension of access to the courses, according to reporter Benjamin Ryan in the New York Sun. The courses remain available on the SEGM website.

(Meanwhile, continuing medical education modules provided by the American Medical Association promote gender-affirming care without acknowledging the weakness of the evidence base and not one module focuses on the significant risks of these hormonal and surgical interventions, according to the group Do No Harm.)

Psychiatrist Kristopher Kaliebe, who features in one of the SEGM course videos, said that aware as he was of the medical establishment’s bias, he was “still shocked at how quickly the [accrediting authority] caved to activists”. In National Review, he wrote: “The message to physicians couldn’t be clearer: Doctors, you can’t handle the truth. But my fellow physicians—and the vulnerable, confused, and hurting children they treat—need the scientific truth more than ever”.

WSU paediatrician Dr Erica Li, the “matchmaker” who introduced SEGM to her university’s college of medicine, has urged the institution to “stand firm” against trans political pressure which she likened to the Chinese Cultural Revolution endured by her parents.

Writing for the Reality’s Last Stand Substack, she said: “There is a serious clinical knowledge gap in the US regarding how best to care for children and adolescents claiming gender-related distress. To treat these patients responsibly, that gap must be filled”.

“SEGM, as an organization dedicated to scientific rigor and the principles of evidence-based medicine, has been a leader in trying to do exactly that. Unfortunately, any effort to apply the same standards of evidence and ethics to pediatric gender medicine that we apply to every other area of medicine inevitably faces ferocious opposition—just as we see now”.

Gender fraud suspected

America | Boston Children’s Hospital (BCH), the site of the first specialist gender clinic in the US, appears to have been falsely diagnosing gender-distressed patients with central precocious puberty (CPP) in order to secure health insurance coverage, according to a court filing by the US government, which is seeking patient records. Insurance claims data allegedly shows hundreds of minors first diagnosed with CPP at age 10 and considerably older. The hospital’s own website recognises that CPP is typically diagnosed in girls whose sexual development begins before 8 and in boys before 9, the Daily Caller reported.

“Because 10 is a normal and not a precocious age for puberty, the large scale of these late diagnoses raises suspicion that BCH incorrectly diagnosed certain children with CPP in order to mislead insurance companies or others into covering puberty blockers for older children with gender dysphoria,” the Department of Justice court filing said.

“Misleading insurance companies or others about a patient’s diagnosis in order to obtain payment for off-label pharmaceuticals could form the basis of a federal healthcare offense.” Puberty blockers are licensed for CPP but not for gender dysphoria.

In a Michigan House of Representatives hearing earlier this month, 23-year-old detransitioner Jonni Skinner—effeminate and bullied as a boy, then put on oestrogen at age 14—testified he did not realise his doctor had diagnosed him with a non-existent “endocrine disorder”. “He never discussed what he was putting in my records so … we were not informed as to those diagnoses until much later when we pursued my medical records,” Skinner said. Representative Brad Paquette said this seemed to be “insurance fraud”.

In a recently filed Massachusetts case, July Carlan aka Shape Shifter alleges that Fenway Community Health Centre failed to detect his “internalised homophobia”, and in effect “converted a [22-year-old] gay man to transgender” with the cross-sex hormone oestrogen via the fast-track “informed consent” model. Fenway, the lawsuit claims, “ignored obvious signs that [Carlan] did not have realistic expectations about the outcomes of transitioning such as the desire to get pregnant”. At one point, Fenway recorded the false diagnosis of “agenesis of the cervix”, meaning the congenital absence of a cervix in a female.

Sub rosa

Australia | In Queensland, the first Australian state to pause puberty blockers and cross-sex hormones, the reporting deadline for an independent review of the evidence base falls today. Asked by GCN whether the report would be published, the office of the centre-right LNP Party Health Minister Tim Nicholls would only say that the review findings by psychiatrist Professor Ruth Vine would be presented to Queensland Health’s director-general by today and then be considered by Cabinet.

Update | Queensland’s centre-left Labor Party, a zealous supporter of paediatric medical transition, has been surprised by some rank-and-file dissent. At the party conference in Brisbane on November 30, there was an attempt to inject caution into a resolution demanding “the immediate resumption of gender-affirming treatment to trans young people” in the state’s public health sector.

An amendment, reportedly put up by delegates from a socially conservative trade union—the Shop, Distributive and Allied Employees’ Association (SDA)—urged counselling before medical intervention for those with gender dysphoria. This amendment was “ultimately voted down,” ABC News reported.

A Left-faction email celebrated its performance at the conference, citing “resolutions in solidarity with the trans and gender-diverse community, and supporting the rights of intersex people to bodily agency, self-determination and autonomy, including in medical settings”.

“… we unfortunately saw delegates from the SDA try to limit access to gender-affirming care for young people, in line with the views of loud and proud transphobes. But we were proud to stand with our comrades in Rainbow Labor and fight against these attacks on conference floor.”

In government, Labor’s then Health Minister Shannon Fentiman, a member of the Left faction, presided over a flawed 2023-24 review of the gender clinic at the Queensland Children’s Hospital.

Coming to court soon

America | The US Supreme Court has declined to hear a case involving parents who claimed a Colorado school district had discouraged their trans-identified children from telling them about this significant change. The parents claimed the mental health of their children declined, including in one case an attempted suicide, after they attended a Gender and Sexualities Alliance club meeting, where an instructor had warned them not to tell their parents about their newfound identities.

The apex court denied the parents’ petition on procedural grounds but Justice Samuel Alito—supported by two other conservatives on the bench, Justice Clarence Thomas and Neil Gorsuch—issued a statement of concern that federal courts appeared to be avoiding the question whether parents had a constitutional right to be told of a child’s gender transition at school.

Their statement said: “[The Colorado parents] tell us that nearly 6,000 public schools have policies—as [this school district] allegedly does—that purposefully interfere with parents’ access to critical information about their children’s gender identity choices and school personnel’s involvement in and influence on those choices. The troubling—and tragic—allegations in this case underscore the ‘great and growing national importance’ of the question that these parent petitioners present”.

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GCN does not dispute that gender-affirming clinicians believe their interventions benefit vulnerable youth

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1. Update, December 2 | The Chilean detransitioner and researcher Nicolás Raveau has pointed out that the decision by Congress not to allocate funds to the PAIG program next year relates to the budget of the Ministry of Social Development, not the Ministry of Health, which is another source of money for this gender ideology program.

The group Kairós agrees that the future of the PAIG’s psychosocial teams in hospitals is unclear but highlights the fact that the health ministry itself has not formally obtained funding for the program in 2026. “It should also be noted that a new government, most likely of the hard right, will take office next March, so the budgetary blow to the PAIG could be the beginning of the end of this program, at least as it has been operating until now,” the group tells GCN.

Raveau added: “It is important that the discussion now moves into the realm of private healthcare, such as the Catholic University and the German Clinic. As well, paediatric and endocrinology medical societies are fully clinically affirmative”.

“It is necessary to pressure the Catholic University to publish new guidelines following the suspension of hormone therapy for children and adolescents, as well as an update to its paediatrics manual (2020), whose procedure is identical to that of the PAIG.”