Gender beat

Prosecuting the Dutch protocol; still waiting for evidence in NZ; Texas whistleblowers; Chile's treatment pause; US lawfare; post-Cass Denmark; UK counsellors in conflict; Norway's gender doc loses

Photo by Peter Lawrence on Unsplash

GCN in brief

First lawsuit

Netherlands | The Amsterdam gender clinic famous for the “Dutch protocol” is being taken to court by two detransitioners who say they were misdiagnosed. The story of “Sam”, a young man who identified as a woman and had hormonal and surgical interventions at the VU University Medical Centre, has been broadcast by the high-profile TV current affairs program EenVandaag. At age 16, Sam said, he was introduced to trans identity by a TV program about a trans boy. “I was already feeling very unhappy,” he said. “I also found out I was attracted to men… I really didn’t want that.” At 22, “very obsessive” about his body and contemplating the next surgery, he decided this would never end with him happy. He detransitioned. Looking back, he believed he had been misled and that the VU gender clinic failed to consider the full extent of his problems. “From the moment I signed up there, it was just one-way traffic. There was only talk about medication, operations… other solutions didn’t get mentioned.”

A spokeswoman for the Dutch group, Genderpunt, which seeks open debate about the implications of gender ideology, told GCN that the joint civil action by the two detransitioners was the first such litigation in the Netherlands. “Gender-affirming care can be discussed in newspapers and questions may be asked in parliament, but a case like this from patients themselves who regret their transition is far more powerful.”

The lawyer for the detransitioners, Johan Oosterhagen, who is reportedly handling 10 gender medicine cases, said such clients “struggle with all kinds of issues” and they saw medicalised gender change as a solution. “Sometimes, they have problems for which [transition] is not a solution… some have a history of sexual abuse and a resulting trauma, [some] struggle with depression and [some with] their sexual orientation.” Mr Oosterhagen said the patient’s body could be changed in the way desired, but if all the problems in the background were ignored, “then the patient is essentially no happier.” In the case of Sam (not his real name), VU has rejected liability and insisted that its gender clinicians work carefully in line with professional standards. There are more than 2,000 minors on the waiting list for gender medicine in the Netherlands, according to the Dutch Ministry of Health.

Video: “I was again very obsessive about my body, I was looking for new things to change. I thought, if I keep going, it will never come to an end”—Dutch detransitioner “Sam”

Just too young

New Zealand | New Zealand’s acting prime minister, Winston Peters, has cast doubt on the capacity of minors to consent to medicalised gender change. Asked about the issue in the context of England’s Cass review, Mr Peters expressed concern about young people mistakenly making irreversible decisions. “And they’ll be living their life with that mistake, because adults didn’t have enough courage or common sense to ask them to wait until they could make a decision at an age of maturity,” he said earlier this month in an interview with Bob McCoskrie, founder of the Christian watchdog group Family First NZ. Mr Peters said: “Young people unable to make up their mind are being destroyed for life, by what I might call loose, liberal views of their entitlement to make decisions at an early time when their minds are not [fully developed]. Go and ask any criminal lawyer—and the first thing they say when somebody is under a certain age is that this person is not fully mature yet.” Mr Peters’ New Zealand First New Zealand party is a member of the country’s governing centre-right coalition.

New Zealand awaits the long-delayed results of an “evidence brief” on puberty blockers from the Ministry of Health. In 2022, the ministry quietly abandoned its public website claim that blockers were “safe and fully reversible.” That change recognised the shift to caution on gender medicine in Europe. The latest delay in publishing the verdict of the NZ evidence brief on blockers has been attributed to April’s Cass report.

Harming not healing

America | The identity of a second whistleblower at the Texas Children’s Hospital—home to a controversial gender medicine program—has been revealed. Vanessa Sivadge, a nurse, came to believe that the underlying problems of minors—such as depression, addiction and discomfort with puberty—were being ignored in favour of gender medicalisation. She told journalist Christopher Rufo: “In the cardiac clinic, we were taking sick kids and making them better. In the transgender clinic, it was the opposite. We were harming these kids.” Last year, Sivadge said, FBI agents came to her home and told her she was a “person of interest” in their investigation of the whistleblower later identified as surgeon Eithan Haim. At the hospital, Sivadge said she had noticed discrepancies in paperwork suggesting that gender medicine was being billed to the government-funded Texas Medicaid program, which was not supposed to cover such procedures. Texas Attorney-General Ken Paxton has announced an investigation into possible Medicaid fraud. Meanwhile, indictments against Dr Haim, brought by the Biden Administration’s Department of Justice, have been unsealed. They accuse the surgeon of unlawfully obtaining patient information. Dr Haim has said that only de-identified information was passed to Mr Rufo in order to confirm that, contrary to its public statements, the hospital was continuing to practise gender medicine. Dr Haim faces penalties up to 10 years in prison.

The case against Dr Haim has been condemned in various quarters. In a letter to US Attorney-General Merrick Garland and FBI Director Christopher Wray, Republican Senator Josh Hawley said the prosecution was “an unconscionable abuse of legal process, in service of shoddy and irresponsible gender ideology.” In the magazine National Review, lawyer Ed Whelan, who holds the Antonin Scalia Chair in Constitutional Studies at the Ethics and Public Policy Center, wrote: “If a whistleblower did what Dr Haim is alleged to have done to expose, say, that a hospital had committed racial discrimination or Medicaid fraud, it is unfathomable that [the Department of Justice] would threaten the whistleblower with a life-destroying criminal prosecution. The only reason that Dr Haim is being targeted is that he has run afoul of the transgender ideology that dominates the Biden Administration. Without any supporting allegations, the indictment contends that Dr Haim acted with ‘malicious intent’ and sought ‘to cause malicious harm’ to the hospital’s physicians and patients. I am not aware of an iota of evidence that would suggest that Dr Haim acted with malice. In his own words, ‘I knew that it was my moral responsibility to expose what was happening to these children’.”

Hold off for now

Chile | The Ministry of Health in Chile has suggested there be no new treatment of minors with puberty blockers or cross-sex hormones in the public health system while an expert committee draws up new national guidelines. The shift in position follows breakthrough coverage of the gender medicine debate—including the Cass report—by journalist Sabine Drysdale on the news site BíoBíoChile. At a June 15 media conference, the undersecretary for public health, Andrea Albagli, said: “The current evidence available is of a low level of certainty, so there is no scientific consensus regarding the long-term consequences of hormone therapy and that is why we have convened a roundtable with more experts to expand the literature review.” Ms Albagli also stressed that clinical work had to continue “in the face of scientific uncertainty” and that specialist clinical experience had to be included in new treatment recommendations. In a June 14 statement, the ministry said it “suggests deferral” of new hormonal treatment until new guidelines are published. Treatment of current patients would continue. The statement does not mention the Cass report, but coverage in the newspaper El Mercurio makes the link.

The ministry said the expert guideline committee included representatives of the Chilean Society of Paediatrics and the Chilean Society of Child and Adolescent Gynaecology. After their first meeting, a photo of the committee was released, but without names or positions of members, leading some parents to fear a pro-affirmative bias and call for transparency. On June 13, the Chilean Society of Endocrinology and Diabetes issued a statement flowing from an analysis of the Cass report. In part, the statement said: “We agree that hormonal interventions [should not be] first-line treatments and that not all adolescents need these pharmacological therapies. We agree that we need better quality scientific evidence about the effects of hormonal treatments and that more studies are needed to clarify the long-term benefits and adverse effects.”

Video: Emma Thomas gives voice to children of parents who transition

Take it to the top

America | The US Supreme Court has agreed to weigh in on the judicial conflict over state laws restricting gender medicalisation of minors. The court, the highest in the US, will hear the Biden administration’s appeal against a decision upholding Tennessee’s law banning puberty blockers and cross-sex hormones. “The eventual ruling, expected in the [northern] spring of 2025, could be a landmark precedent on the scope of the Constitution’s Equal Protection Clause, which guarantees people equal treatment under the law,” The Wall Street Journal reported. In the Tennessee case, a federal appeals court held the state law to be constitutional. The chief judge of that court wrote: “The unsettled, developing, in truth still experimental, nature of treatments in this area surely permits more than one policy approach, and the Constitution does not favour one over the other.” Half of America’s 50 states have banned or limited “gender-affirming” medical interventions.

A “friend of the court” brief filed by Alabama says that the case for invalidity of Tennessee’s ban depends on the reliability of treatment guidelines issued by the World Professional Association for Transgender Health (WPATH). The brief says: “From what can be gleaned from the public record, WPATH is no normal medical organisation. Its guidelines purport to be evidence-based, but WPATH admits it skipped the foundational step of conducting a systematic evidence review when it crafted its treatment recommendations for adolescents. It routinely suppresses scientific inquiry, silencing scholars who question the WPATH standard of ‘care’ and censuring members who go public with their concerns. And many clinicians don’t follow the WPATH standards anyway, as a survey of WPATH’s own doctors shows—and as story after tragic story of inadequate care at gender clinics confirm.”

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Denmark | Journalist Dorte Toft surveys the post-Cass scene

What's Going on in Denmark? A Critical Look at Gender Identity in Education and Public Institutions

Memo of misunderstanding

United Kingdom | The UK Council for Psychotherapy (UKCP) faces a test of leadership following its decision to withdraw from an “anti-conversion therapy” memorandum of understanding (MoU). The MoU, signed by many therapy associations and employers such as England’s National Health Service (NHS), was reportedly updated to cover children without the UKCP being consulted. The anti-conversion remit of the MoU was also extended from sexual orientation to the more nebulous concept of “gender identity”. An “anti-transphobia” group of therapists objected to the withdrawal from the MoU, and a vote of confidence in the UKCP board of trustees is being held until July 3. Peter Jenkins, of the group Thoughtful Therapists, has written a defence of the withdrawal decision.

He said the MoU, influenced by the World Professional Association for Transgender Health, had been used “to justify the widespread use of gender identity affirmative therapy” at the London-based NHS Tavistock paediatric gender clinic. Mr Jenkins cited the interim report of the Cass review and its warning against “diagnostic overshadowing”, whereby “a self-declared gender identity meant that further exploratory therapy would be considered unnecessary in many cases. This led to rapid medicalisation and potentially devastating longer-term health consequences for many young clients.” More at this webinar with Mr Jenkins and existential psychotherapist Tamara Sears in discussion.

Doctor is out

Norway | A prominent Norwegian gender clinician, Esben “Esther Pirelli” Benestad, who identifies as a woman, has lost the right to practise, the magazine Reduxx has reported, noting that, “Benestad had previously been scrutinised for giving puberty-halting drugs to adolescents under questionable circumstances, and for falsifying medical diagnoses in order to recommend underage girls for double mastectomies.” In March 2023, Norway’s independent Healthcare Investigation Board concluded that medicalised gender change for minors was “experimental”. The medical directors of Norway’s four health regions agreed with this verdict in February this year.