Detransition in the spotlight

Plus: Not so cautious Swedes; Dutch protocol bias; missing health data; another blow to WPATH; sex-role colonialism; fair trade probe into US gender business; win for NZ lawyer who warned on blockers

Photo by Helena Lopes on Unsplash

GCN global briefs

Detrans clinic

America | A non-profit medical clinic for US detransitioners is in planning, a historic meeting of 70-plus detransitioners hosted by Genspect in Washington DC has heard. Katy Hurd, a Seattle-based family physician with her own history of gender dysphoria, told the March 12 Life Beyond Transition conference that the needs of detransitioners—including their complications from hormonal treatment and transgender surgery—represented an “abominable” gap in healthcare. She said the proposed Seattle area clinic might open a year after a start is made with a telehealth service in six months or so; some US$500,000 in funds would have to be raised.

Apart from detransitioners, the clinic would cater to people who are gender-questioning or those “who are mostly content with their transition but just want a second opinion”. Dr Hurd said she hoped the clinic could serve as a model for others.

But such clinics would not be able to charge for services until the ICD diagnostic system is updated with billing codes for detransition. Kurt Miceli of the medical watchdog group Do No Harm told the conference that a proposal for ICD codes covering desistance and detransition in its various forms would be put to the Centers for Disease Control and Prevention on March 17. Not only would new codes lead to better healthcare and insurance cover for detransitioners, they would also generate hard data disproving activist claims that transition regret is negligible.

On litigation, a conference panel of lawyers addressed the popular misconception that lawsuits should have swiftly and easily shut down the abuses of paediatric gender medicine. The obstacles and delays facing detransitioner claims included short statutes of limitations barring actions in many states, low caps on damages awards, the hefty cost of expert reports for plaintiffs, and the time chewed up by appeal points.

Even so, the recent $2 million award to detransitioner Fox Varian showed the potential for claims by vulnerable young people to succeed if they can be brought before a jury. Such awards, settlements and even unsuccessful claims could influence legislators to extend statutes of limitations and cause hospital risk managers to back away from paediatric gender medicine. The panel agreed that crunch time would come when medical indemnity insurers withdrew coverage for puberty blockers, cross-sex hormones and gender surgery, exposing doctors to personal liability.

“Because if there’s a $20 million verdict against a surgeon, instead of it being capped and the insurance company paying for it, that surgeon is losing his house,” litigator Kevin Keller said. “He’s uncovered, personally exposed ... that’s what will make them stop doing this.”

Detrans chat

International | Web developer Peter James Steven has created an AI chatbot to disseminate the stories of detransitioners. He came to the topic knowing people who had seen transition as the only answer to their plight. Then he discovered other answers in detransition narratives. “Ethical healthcare would prioritise helping people work through their problems and learn to love themselves,” he says.

“Gender-affirming care is a band-aid solution that’s deployed with an ideological rigidity that shuts down alternatives. Detrans AI exists to make those alternatives visible: people who worked through their distress, who found other paths, who want their stories counted in a conversation that currently excludes them.” His Q&A chatbot, which mines the Reddit r/detrans community and YouTube, is available in 33 languages.

Not so cautious

Sweden | Some gender clinics are ignoring Sweden’s strict national guidelines and pushing ahead with puberty blockers and cross-sex hormones for minors, the Göteborgs-Posten newspaper has reported. In 2022, the country’s National Board of Health and Welfare issued new guidelines, acknowledging the weak evidence base and advising these hormonal treatments only be given in “exceptional” cases outside clinical trials. But new countrywide figures for 2024 show small increases in the total number of minors on blockers (70, up by 2) and hormones (171, up 6) compared with the year before the board’s 2022 guidelines.

“Several clinics have continued with hormone treatment even though [the board] advises against it in most cases,” Göteborgs-Posten said in its article headlined “Transition of children continues: did we really pull the emergency brake?”.

Marking their own homework

The Netherlands | Dutch Health Minister Sophie Hermans has defended the credibility of an inquiry into the medico-legal compliance of paediatric gender medicine in the country that created the “Dutch protocol”. In December last year, legal scholar Professor Lodewijk Smeehuijzen published a critique of the inquiry by the independent Health Council. He raised concerns about its committee makeup, bias and conflicts of interest likely to favour the Dutch protocol. “According to Smeehuijzen, the Health Council’s advisory committee is poorly equipped to meet that mandate,” Hermes Postma wrote for Genspect’s Substack, Inspecting Gender.

“Of its twelve members, six are directly or indirectly involved in prescribing puberty blockers or cross-sex hormones, and several are affiliated with the institutions that developed, implemented, and publicly defended the Dutch protocol. Those same institutions would face significant reputational, professional, and potentially legal consequences if the practice were deemed unlawful or scientifically unsound.”

In her March 9 response to parliamentary questions about the Smeehuijzen critique, Minister Hermans said it was the responsibility of the Health Council to guarantee the independence of its advice. On the crossover between committee members and practitioners of the Dutch protocol, Hermans said the council had given consideration to “whether the [appointed] experts came from different university medical centres, universities and research institutions”.

“The committee also consulted various clinical experts from England, France, Germany and Sweden, with varying perspectives on transgender care for young people.” Professor Smeehuijzen had been invited by the council to “share his knowledge and objections”. Hermans said the Dutch Cabinet would send its policy response to the parliament once the council’s advice was published, which is now expected to be in the second quarter of this year.

A retrospective chart study at the Amsterdam gender clinic most associated with the Dutch protocol has found that not meeting the criteria for a gender dysphoria diagnosis and serious mental health problems were the two main reasons for under-18 patients not going down the path to hormonal treatment. Even so, roughly a quarter of those not medicalised had received a dysphoria diagnosis. Of 1,470 patients given a first assessment between 2009 and 2019, 264 did not proceed to puberty blockers or cross-sex hormones; 76 of those patients were re-referred to the clinic as adults.

“These findings underline the importance of comprehensive diagnostic exploratory trajectories with a holistic and developmental approach, also focusing on whether adolescence is the right timing for [hormonal treatment], before considering any medical interventions in gender incongruent youth,” the researchers said. Their paper concedes that social media and peer networks are one possible reason for the international surge in youth gender clinic caseloads.

Dr Oz weighs in

America | A senior health official in the Trump Administration, Mehmet Oz, who is Administrator for the Centers for Medicare & Medicaid Services, has intervened in the dispute over the shutdown of the paediatric gender clinic at NYU Langone Medical Center. New York state Attorney General Letitia James has threatened legal action if the clinic is not reopened. In a letter to James, Dr Oz defended the shutdown, saying “Our children are not guinea pigs,” The New York Post reported.

“Given that emerging medical evidence continues to demonstrate the harm these procedures inflict on children, it is both irresponsible and false to declare the other side of this ongoing scientific debate definitively ‘medically necessary.’” Dr Oz continued, “It is worse still to compel doctors to perform procedures that remain the subject of substantial dispute. It is also unethical. Your claim that discontinuing these interventions constitutes unlawful discrimination is irresponsible.”

Missing data

Australia | “Six of Australia’s eight states and territories have refused to release any data on the number of children prescribed puberty blockers to treat gender dysphoria, maintaining a veil of secrecy that prevents proper oversight of the highly controversial treatment,” The Australian has reported. The newspaper quoted experts saying this lack of information would not be considered acceptable for any other medical condition. An analysis of incomplete data obtained under Freedom of Information law suggested at least 2,387 children were put on hormone suppression for gender dysphoria between 2014 and 2025.

The state of Queensland has paused new prescriptions of blockers and hormones for minors with gender dysphoria on safety grounds. As a senior staffer at the Queensland Children’s Hospital, home to a paediatric gender clinic, psychiatrist Jillian Spencer was an early voice for caution but was accused of misconduct for speaking out publicly. A termination letter sent her last year by hospital management may have been an unlawful reprisal action, according to the state Crime and Corruption Commission, The Courier-Mail has reported. However, the commission said it would not intervene while Dr Spencer was fighting for her job in separate court proceedings.

Misguided

International | A quality assessment of the World Professional Association for Transgender Health’s current standards of care, known as SOC-8, has found “important flaws in their development, notably a lack of scientific rigor and opaque conflict of interest management, which could undermine the trust in these recommendations”. The project, involving eight assessors with “diverse views”, advised against uncritical adoption by clinicians of the WPATH treatment standards. “The methodology limitations of the guidelines could hinder the delivery of optimal healthcare to vulnerable youth,” the peer-reviewed evaluation paper warns.

WPATH’s document, crafted with a view to securing insurance coverage and fending off litigation, suffers from debilitating internal contradictions, according to an article in The Dispatch. Joseph Figliolia writes that “while less attuned observers tend to assume that ostensible safety guardrails and nods to psychological assessment in WPATH’s guidelines make patient regret and harm unlikely, the guidelines’ emphasis on affirmation is at odds with the clinical concept of ‘differential diagnosis’.”

“WPATH’s guidelines implicitly deprioritize differential diagnosis—drawing clinically meaningful distinctions between disorders that have overlapping symptoms or expressions—by maintaining that other complex mental health challenges are really just secondary to the experience of dysphoria, and not possible drivers of distress.

“[And] despite often deploying the language of ‘medical necessity,’ WPATH’s SOC-8 pulls a bait and switch by embracing the ‘gender incongruence’ classification—as opposed to ‘gender dysphoria’—which removes distress as key diagnostic feature and conceptualizes ‘gender diversity’ as a normal, entirely non-pathological way of being in the world. It’s unclear, however, how this understanding of ‘gender incongruence’ necessitates the need for invasive medical interventions.”

More proof of no proof

United Kingdom | The National Health Service has released ten new systematic reviews of the evidence on puberty blockers and cross-sex hormones for minors, following its decision to pause hormone use with 16 and 17-year-olds for lack of good evidence. “The new reviews add to a list of now over 20 systematic reviews, all of which come to the conclusion: evidence is insufficient to support the practice of pediatric medical gender transition,” the Society for Evidence-based Gender Medicine said. The NHS documents also note that the service is reviewing the evidence for cross-sex hormones use by adults.

More US manoeuvres

America | Texas congressman Dan Crenshaw has introduced to the House of Representatives a federal bill to frustrate the practice of Democratic states setting themselves up as “trans sanctuaries” for minors fleeing restrictions on medical transition in Republican states. “Children should not be transported across state lines to undergo irreversible medical procedures that are abusive and harmful just to circumvent home state laws or keep parents and guardians in the dark,” said Crenshaw, a Republican.

The US Department of Health and Human Services is investigating a series of “federally qualified health centers”—among them Whitman-Walker Health in Washington, DC—over what it describes as “sex-rejecting procedures”. And Republican Senator Bill Cassidy, a physician, has asked the Department of Health and Human Services (HHS) to release emails and communications written by the agency’s Biden-era assistant secretary Rachel Levine, a paediatrician and trans-identified male who aggressively promoted medical transition for minors, The Daily Wire has reported. The communications sought include interactions about the trans agenda between Dr Levine, the White House and medical organisations.

Gender colonialism

International | Genspect has published an essay illuminating for anyone curious about the claim that indigenous traditions lend credence to gender ideology. “Rather than ‘indigenous ways of knowing’ teaching us more expansive definitions of gender, indigenous peoples [in Southeast Asia] have been sexually exploited by a prostitution and transition industry built on the customer’s gender stereotypes, constantly in search of the novel and the exotic-erotic in order to develop and grow new markets,” the essay says. The customers were often served up by European colonialism.

Consumer shield

America | The US Federal Trade Commission has launched a consumer protection investigation into the American Academy of Pediatrics (AAP) and the World Professional Association for Transgender Health (WPATH), Bloomberg has reported. The commission sent legal demands for documents and testimony to both entities on January 15 relevant to whether they have made false or unsubstantiated claims when marketing treatment for paediatric gender dysphoria.

Those demands include all WPATH’s communications with medical organisations over its current treatment standards, known as SOC-8, as well as all communications related to the systematic evidence reviews requested from Johns Hopkins University. AAP is being asked for information on the development of its contentious 2018 “affirmation-only” policy statement, including all participating individuals and entities and any funding source. Both AAP and WPATH challenge the commission’s authority to take this action. In July 2025, the commission held a workshop on “The Dangers of ‘Gender-Affirming Care’ for Minors”.

Not popular

America | A new poll of Democratic supporters reveals more mainstream, cautious attitudes than suggested by party policy. The Manhattan Institute poll involved 2,593 people who were either registered Democrats and/or voted for Kamala Harris in 2024. Only 21 per cent of respondents agreed with transgender medical interventions under 18. Only 32 per cent of radical respondents, described as “woke fringe”, endorsed these interventions for minors.

As time goes by, public opposition to paediatric medical transition is becoming more pronounced in the US. In a recent survey by The Argument of 3,003 registered voters, 56 per cent were against puberty blockers and cross-sex hormones for minors, even with “doctoral and parental consent”. A substantial minority of voters (31 per cent) for Kamala Harris also vetoed these medical interventions. On gender surgery for minors, 62 per cent were in opposition, including 45 per cent of parents who voted for Harris. The Argument, a Left-leaning Substack, said “it’s worth noting that Americans used to be more progressive on these issues. Even as late as 2024, Gallup found a majority of voters more aligned with the progressive viewpoint on this. The backsliding on this is sharp and recent.”

The Manhattan Institute’s Leor Sapir noted that those polled did not appear very reassured by the fact that doctors were advising these medical treatments. “The poll’s results thus imply that Americans don’t trust doctors—in particular, it would seem, doctors with ‘gender’ expertise—to make the right decision when it comes to helping children and adolescents who experience discomfort with their sex,” Sapir said.

It’s what lawyers do

New Zealand | A finding of unsatisfactory conduct against a lawyer who warned gender clinicians about their exposure to legal liability has been overturned. Acting for clients, Stephen Franks of Franks Ogilvie sent letters last year to 20 health practitioners warning them of the potential legal risks in prescribing gender medicine such as puberty blockers. After complaints, a New Zealand Law Society committee found Franks had used the law “for an improper purpose, including for the purpose of causing unnecessary distress to another person’s reputation or occupation”.

That finding “cannot stand”, according to a recent decision by Legal Complaints Review Officer Fraser Goldsmith. “The very purpose of a lawyer or firm sending a letter on behalf of a client is, in many if not most instances, to endeavour to lend weight to whatever concern, position or purpose the client seeks to express or advance. That is what lawyers do. This is why a client comes to its lawyer and says, ‘we need a lawyer’s letter about this’. This cannot conceivably be improper in principle.” Goldsmith also noted that none of the six people who complained had received the letter. Since Franks sent the warning, the NZ government has announced a policy banning new prescription of puberty blockers. A judicial review challenging that policy is to be heard in May.

Big spend

America | More than US$ 135 million was spent on paediatric gender medicine over five years from 2019, according to an analysis of US congressional budget data published in the journal JAMA Pediatrics. That amount was paid under the government Medicaid fund and the Children’s Health Insurance Program. The lion’s share was accounted for by off-label puberty blocker drugs, the rest spent on surgery and cross-sex hormones.

“This sum [of $135m] likely marks the end, at least for now, of substantial public spending on these medical interventions, given the intense and widespread opposition among Republican elected officials to paediatric gender medicine,” journalist Benjamin Ryan reported.