The Oregon Health and Science University Gender Clinic is a leading promoter of the medicalized, ideologically affirming approach to childhood and adolescent gender distress—and it operates in my adopted hometown of Portland. That’s why I’ve focused my attention here. With federal oversight or reform of such clinics long overdue, for now we’re left to scrutinize the public-facing materials ourselves.
One revealing feature of the clinic’s website is the curated set of promotional images, which seem more aligned with identity politics branding than with the delivery of evidence-based, ethically grounded health care. If gender identity is supposed to be an internal sense rather than a performance, the visual messaging raises a fair question: why is it so often about visibility?
On that page, OHSU promotes its version of gender ideology—content that resembles indoctrination more than medicine. I have provided parenthetical notes that supply context and cautions that any responsible informed consent process ought to include.
GENDER IDENTITY IN CHILDREN AND TEENS
IN CHILDREN
Gender awareness: Children usually develop some sense of their gender by age 2 to 4.
(The concept of "gender" is contested: critics argue it is a socially constructed set of stereotypes rather than an innate identity. The claim that toddlers "sense" an internal gender relies on circular reasoning—children associate themselves with certain behaviors or preferences, and these are then used to retroactively assign them an identity. Biological sex is a definable characteristic; "gender" remains fluid and context-dependent.)
It’s common — and normal — for young children to want to look, talk and act like someone of a different gender.
(This is true and typically represents imaginative play or nonconformity, not an identity. The text fails to mention that most gender nonconforming children grow up to be gay or lesbian, not transgender—a critical omission.)
For many, this doesn’t last beyond puberty.
(Accurate but downplayed: multiple studies show that the majority of children with cross-gender identification or behavior desist and instead identify as same-sex attracted adults. This fact is often omitted or minimized in affirming models of care.)
Gender identity: Children are varying ages when they recognize that their gender identity is different from the one they were assigned at birth.
(“Assigned at birth” is an ideological euphemism. In almost all cases, sex is observed and recorded based on anatomy—it is not arbitrarily “assigned.” Also, the notion of a fixed, internal "gender identity" emerging in early childhood lacks robust empirical validation and is based on subjective reports.)
Many are as young as 3 or 4.
(Claims of gender identity at age 3 or 4 are highly disputed. Young children lack the cognitive maturity to understand abstract identity concepts. Their statements often reflect social influences or preferences, not stable identities.)
Others may not have this awareness until puberty or later.
(This is true, but again the framing presumes a stable, innate gender identity awaiting discovery, a position that remains scientifically unproven.)
Gender expression: There’s no typical way in which children express gender diversity.
(This statement is vague and blurs the distinction between personality, behavior, and identity. Not all forms of nonconformity imply a different identity. This framing encourages pathologizing or reifying atypical behavior.)
Some, seeking to please their family or fit in at school, may not express it at all.
(This suggests that unexpressed gender diversity is common, which is speculative and may encourage clinicians or parents to interpret ordinary behavior through an ideological lens.)
Gender dysphoria: Gender dysphoria refers to the discomfort some young people feel about their gender identity not matching the gender they were assigned at birth.
(Again, “assigned at birth” is ideologically charged and misleading—biological sex is observed, not imposed. This framing promotes the idea that a subjective identity can override objective sex, which is a matter of ongoing ethical and scientific debate.)
It often emerges or becomes apparent in kindergarten or first grade, when expectations to conform to gender roles increase.
(This is speculative and sociologically framed. It implies that dysphoria is socially induced, which raises the question of why identity-based interventions are prescribed rather than addressing the child’s distress or environment.)
Children often become distressed about not being able to wear the clothes they wear at home, for example.
(Distress over clothing restrictions may reflect parental or social rigidity more than an internal gender identity. The example is simplistic and potentially misleading.)
IN TEENS
Gender dysphoria: Some teens become aware of their gender identity or choose to express it at puberty.
(This conflates awareness, identity, and expression. It also avoids discussion of the rapid rise in adolescent-onset dysphoria among natal females, which some researchers link to social contagion or underlying psychological issues such as trauma, autism, or depression.)
The sex traits that develop in puberty — such as chest development, body hair or voice changes — can intensify or lead to gender dysphoria.
(“Chest development” is a euphemism for breast development and obscures the reality of what causes distress for many natal females. This vagueness may facilitate medical intervention without informed clarity. Also, the framing suggests a one-way causal link between puberty and dysphoria, ignoring the complex biopsychosocial context.)
Gender dysphoria in teens is highly likely to last into adulthood.
(This is a contested claim. While some studies on clinically referred youth—especially those who begin medical transition—report persistence, these samples are subject to selection bias. Other research suggests that many cases of adolescent-onset gender dysphoria, particularly among natal females, may be transient. Moreover, longitudinal studies from earlier cohorts indicate that the majority of gender-dysphoric teens—especially those who are not socially or medically transitioned—will desist and go on to identify as gay or lesbian. Critics argue that early affirmation and medicalization can derail normal psychosexual development, locking in a transgender identity that might otherwise have resolved into same-sex attraction.)
Emotional issues: Gender dysphoria can worsen emotional issues that often come with puberty, such as anxiety and depression.
(This is plausible, but it implies that dysphoria is the root cause of emotional distress rather than a symptom. Many teens who identify as trans have preexisting mental health issues. The direction of causality is unclear.)
Teens with gender dysphoria are twice as likely to have suicidal thoughts as other teens, research shows.
(This figure has been widely cited but is disputed. It often comes from surveys of self-selected samples or cross-sectional studies that cannot determine causality. Suicidality is elevated in many marginalized or distressed populations, not just those with gender dysphoria. Importantly, the text omits that no robust evidence shows medical transition reduces suicide risk long-term.)
Detransition refers to the process of discontinuing or reversing some or all of the aspects of gender transition.
. . I reference a recent study titled ‘Reidentification with Birth-Registered Sex in a Western Australian paediatric Gender Clinic Cohort.’ JAMA Paed, March 2024 (described in the press as ‘Perth’s groundbreaking transgender study’).
The study involved 552 clients (children) with two who detransitioned as a result of the ‘reidentification with their birth-registered sex’.
Wize call for the two who bowed out. However, for those countless thousands of children who have completed their ‘transition journey’ and no longer possess their gender-affirming genitals, their detransition process is much more complicated and has a pretty miserable outcome.
I briefly reference three studies demonstrating widely different detransition rates when compared with the Perth ‘groundbreaking study’:
• ‘Survey of 100 Detransitioners’ Arch sexual behaviour’, Nov 2021.
65% of the cohort indicated that ‘if they knew then what they know now they would not have chosen to transition’.
• Detransition among Transgender and Gender-Diverse People-An Increasing and Increasingly Complex Phenomenon, JCEM June 2022
The study examined the rates of cessation of gender-affirming hormones among 952 transgender individuals in the U.S. Military Healthcare System. The overall four-year gender-affirming hormone continuation rate was 70.2%.
• Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently detransitioned: A Survey of 100 Detransitioners
Only 24% had advised their clinic that they had detransitioned.
The Oregon Health and Science University Gender Clinic is a leading promoter of the medicalized, ideologically affirming approach to childhood and adolescent gender distress—and it operates in my adopted hometown of Portland. That’s why I’ve focused my attention here. With federal oversight or reform of such clinics long overdue, for now we’re left to scrutinize the public-facing materials ourselves.
One revealing feature of the clinic’s website is the curated set of promotional images, which seem more aligned with identity politics branding than with the delivery of evidence-based, ethically grounded health care. If gender identity is supposed to be an internal sense rather than a performance, the visual messaging raises a fair question: why is it so often about visibility?
Follow this link to see where the OHSU Gender Clinic markets itself to "Parents, Children and Teens." Can find the clinic's informed consent form? https://www.ohsu.edu/transgender-health/transgender-health-program-parents-children-and-teens
On that page, OHSU promotes its version of gender ideology—content that resembles indoctrination more than medicine. I have provided parenthetical notes that supply context and cautions that any responsible informed consent process ought to include.
GENDER IDENTITY IN CHILDREN AND TEENS
IN CHILDREN
Gender awareness: Children usually develop some sense of their gender by age 2 to 4.
(The concept of "gender" is contested: critics argue it is a socially constructed set of stereotypes rather than an innate identity. The claim that toddlers "sense" an internal gender relies on circular reasoning—children associate themselves with certain behaviors or preferences, and these are then used to retroactively assign them an identity. Biological sex is a definable characteristic; "gender" remains fluid and context-dependent.)
It’s common — and normal — for young children to want to look, talk and act like someone of a different gender.
(This is true and typically represents imaginative play or nonconformity, not an identity. The text fails to mention that most gender nonconforming children grow up to be gay or lesbian, not transgender—a critical omission.)
For many, this doesn’t last beyond puberty.
(Accurate but downplayed: multiple studies show that the majority of children with cross-gender identification or behavior desist and instead identify as same-sex attracted adults. This fact is often omitted or minimized in affirming models of care.)
Gender identity: Children are varying ages when they recognize that their gender identity is different from the one they were assigned at birth.
(“Assigned at birth” is an ideological euphemism. In almost all cases, sex is observed and recorded based on anatomy—it is not arbitrarily “assigned.” Also, the notion of a fixed, internal "gender identity" emerging in early childhood lacks robust empirical validation and is based on subjective reports.)
Many are as young as 3 or 4.
(Claims of gender identity at age 3 or 4 are highly disputed. Young children lack the cognitive maturity to understand abstract identity concepts. Their statements often reflect social influences or preferences, not stable identities.)
Others may not have this awareness until puberty or later.
(This is true, but again the framing presumes a stable, innate gender identity awaiting discovery, a position that remains scientifically unproven.)
Gender expression: There’s no typical way in which children express gender diversity.
(This statement is vague and blurs the distinction between personality, behavior, and identity. Not all forms of nonconformity imply a different identity. This framing encourages pathologizing or reifying atypical behavior.)
Some, seeking to please their family or fit in at school, may not express it at all.
(This suggests that unexpressed gender diversity is common, which is speculative and may encourage clinicians or parents to interpret ordinary behavior through an ideological lens.)
Gender dysphoria: Gender dysphoria refers to the discomfort some young people feel about their gender identity not matching the gender they were assigned at birth.
(Again, “assigned at birth” is ideologically charged and misleading—biological sex is observed, not imposed. This framing promotes the idea that a subjective identity can override objective sex, which is a matter of ongoing ethical and scientific debate.)
It often emerges or becomes apparent in kindergarten or first grade, when expectations to conform to gender roles increase.
(This is speculative and sociologically framed. It implies that dysphoria is socially induced, which raises the question of why identity-based interventions are prescribed rather than addressing the child’s distress or environment.)
Children often become distressed about not being able to wear the clothes they wear at home, for example.
(Distress over clothing restrictions may reflect parental or social rigidity more than an internal gender identity. The example is simplistic and potentially misleading.)
IN TEENS
Gender dysphoria: Some teens become aware of their gender identity or choose to express it at puberty.
(This conflates awareness, identity, and expression. It also avoids discussion of the rapid rise in adolescent-onset dysphoria among natal females, which some researchers link to social contagion or underlying psychological issues such as trauma, autism, or depression.)
The sex traits that develop in puberty — such as chest development, body hair or voice changes — can intensify or lead to gender dysphoria.
(“Chest development” is a euphemism for breast development and obscures the reality of what causes distress for many natal females. This vagueness may facilitate medical intervention without informed clarity. Also, the framing suggests a one-way causal link between puberty and dysphoria, ignoring the complex biopsychosocial context.)
Gender dysphoria in teens is highly likely to last into adulthood.
(This is a contested claim. While some studies on clinically referred youth—especially those who begin medical transition—report persistence, these samples are subject to selection bias. Other research suggests that many cases of adolescent-onset gender dysphoria, particularly among natal females, may be transient. Moreover, longitudinal studies from earlier cohorts indicate that the majority of gender-dysphoric teens—especially those who are not socially or medically transitioned—will desist and go on to identify as gay or lesbian. Critics argue that early affirmation and medicalization can derail normal psychosexual development, locking in a transgender identity that might otherwise have resolved into same-sex attraction.)
Emotional issues: Gender dysphoria can worsen emotional issues that often come with puberty, such as anxiety and depression.
(This is plausible, but it implies that dysphoria is the root cause of emotional distress rather than a symptom. Many teens who identify as trans have preexisting mental health issues. The direction of causality is unclear.)
Teens with gender dysphoria are twice as likely to have suicidal thoughts as other teens, research shows.
(This figure has been widely cited but is disputed. It often comes from surveys of self-selected samples or cross-sectional studies that cannot determine causality. Suicidality is elevated in many marginalized or distressed populations, not just those with gender dysphoria. Importantly, the text omits that no robust evidence shows medical transition reduces suicide risk long-term.)
Byrne 2024 covers the (unsupported) claim that adolescent gender dysphoria is likely to persist. "Another myth"....is the lead of the title...
At last. Oh to have a sensible government in this country. One that protects children from activists.
DETRANSITION:THE INCONVENIENT TRUTH
Detransition refers to the process of discontinuing or reversing some or all of the aspects of gender transition.
. . I reference a recent study titled ‘Reidentification with Birth-Registered Sex in a Western Australian paediatric Gender Clinic Cohort.’ JAMA Paed, March 2024 (described in the press as ‘Perth’s groundbreaking transgender study’).
The study involved 552 clients (children) with two who detransitioned as a result of the ‘reidentification with their birth-registered sex’.
Wize call for the two who bowed out. However, for those countless thousands of children who have completed their ‘transition journey’ and no longer possess their gender-affirming genitals, their detransition process is much more complicated and has a pretty miserable outcome.
I briefly reference three studies demonstrating widely different detransition rates when compared with the Perth ‘groundbreaking study’:
• ‘Survey of 100 Detransitioners’ Arch sexual behaviour’, Nov 2021.
65% of the cohort indicated that ‘if they knew then what they know now they would not have chosen to transition’.
• Detransition among Transgender and Gender-Diverse People-An Increasing and Increasingly Complex Phenomenon, JCEM June 2022
The study examined the rates of cessation of gender-affirming hormones among 952 transgender individuals in the U.S. Military Healthcare System. The overall four-year gender-affirming hormone continuation rate was 70.2%.
• Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently detransitioned: A Survey of 100 Detransitioners
Only 24% had advised their clinic that they had detransitioned.