Gender fraud

Plus: ROGD is a thing; Colombian clinic closure; UK unsafety; Utah study unmasked; no questions for Austria's Pride; Iceland's Gender Gilead; NZ judges warned off activism; French ruling on mastectomy

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GCN global briefs

One for the ages

International | The new “rapid-onset” subtype of gender dysphoria should be recognised in the diagnostic manual DSM, according to a paper by clinical psychologist and researcher Dr Ken Zucker. In the European Journal of Developmental Psychology, he argues there is “emerging evidence” of this new pathway to gender dysphoria, never mind politicised attempts to cancel the 2018 study in which Dr Lisa Littman first described the phenomenon of rapid-onset gender dysphoria (ROGD).

Dr Zucker contends that the age-of-onset of gender dysphoria may point to factors, such as sexual orientation, that help elucidate the causes of this condition, as well as indicating the likely desistance rates for each subtype.

Fluid billings

America | In a settlement with the Trump administration’s Department of Justice, Ohio’s Cleveland Clinic Foundation (CCF) has agreed to commit $2 million to provide healthcare for detransitioners. The American Civil Liberties Union declared itself “deeply saddened” by this “anti-trans settlement”. The CCF also agreed to pay $308,000 to resolve claims—which it disputes—that false billings were used to secure insurance coverage for paediatric medical transition. Last month, Texas Children’s Hospital (TCH) became the first in the US to pledge a detransitioners’ clinic.

Writing in The New York Post, endocrinologist Dr Roy Eappen of the watchdog group Do No Harm said “the heartbreaking plight of today’s ‘detransitioners’ may be among history’s worst examples of deliberate medical neglect.”

“They shouldn’t have to go to Texas or Ohio to get the care they deserve. They should be able to get treatment and find healing at the hospital that hurt them in the first place,” Dr Eappen said.

TCH also agreed to make a $10 million payment to finalise contested allegations of false insurance billings, as part of a settlement reached with the Department of Justice. Whistleblower surgeon Dr Eithan Haim, who in 2023 told journalist Christopher Rufo that TCH was still engaged in gender medicalisation of children despite its promise to stop such procedures, said the $10 million figure represented the second largest healthcare fraud settlement involving an American children’s hospital.

“A question worth asking is how does such a tiny clinic generate $10m in Medicaid fraud claims, especially when those claims exclude private insurance entirely?” Dr Haim said. “The disparity between patient volume and billing volume raises another question: how could so few physicians submit so many allegedly fraudulent claims unless the improper billing practices were the standard practice in the clinic—and how was this not identified [by] the leadership earlier?”

A report from Do No Harm documents the activist promotion of incorrect billing codes in the US. “By misrepresenting the medical procedures they are performing, providers can pass off transgender medicalization as, for example, routine endocrine care unrelated to pediatric medical transition,” the report says.

“These ‘loopholes’ may enable providers to get paid for procedures which otherwise may not be funded. In some cases, such practices may even be outright fraudulent or a means of evading state-level restrictions on child sex change interventions.”

Mount Sinai Health System has joined another Manhattan provider of paediatric gender medicine, NYU Langone Health, as the subject of investigation by the Trump administration, which is seeking patient records. “The government has said it is acting on the behalf of patients and families as it investigates whether health providers and drug companies have illegally promoted off-label use of medications or used fraudulent billing practices to secure insurance coverage for gender-related treatments to minors,” The New York Times reported.

Rhode Island Hospital has also resisted handing over records to the US Department of Justice. A 2023 paper showed 94 per cent of gender patients in the hospital’s adolescent and primary care clinics were given the false diagnosis of “endocrine disorder, unspecified,” a diagnosis supposedly “less stigmatising” than the term “gender identity disorder”. Records showed both diagnoses for 44 per cent of these patients.

Schtum!

Singapore | If the belated media coverage by The Straits Times is any guide, Singapore’s cautious new treatment guidelines for youth gender dysphoria did indeed take effect on May 5 when the Ministry of Health’s alert, with guidelines attached, went out directly to doctors and hospitals.

The news report makes no mention of the fact that the guidelines disappeared from the Ministry’s webpages within days of their upload; there was no reply to questions from GCN. The Times, once known as the “Thunderer of the East”, does cite the Ministry as acknowledging “conflicting schools of thought” on how best to respond to dysphoric youth.

Closed for business

Colombia | The elite Valle del Lili Foundation hospital in the Colombian city of Cali has closed its paediatric gender clinic, according to a Washington Stand interview with neuropsychologist and pro-family congressional adviser Liliana Castañeda, who has campaigned for a legislative ban on the gender medicalisation of minors. She said the closure followed “intense public pressure” generated by a documentary “Colombia: Factory of Trans Children”. The documentary featured a detransitioner, Laura, who underwent hormonal treatment as a minor, and has launched a legal claim against the hospital.

In response to news of her claim in November 2025, the hospital defended itself as “an academic and scientific institution committed to training, research and high-quality care, guided by the principles of medical ethics and international standards”. GCN sought comment from the hospital about the status of its gender clinic. Laura’s lawyers, it is understood, have confirmed that gender medicalisation for minors is no longer offered by the hospital.

In 2018, the clinic’s director, Dr Mario Angulo Mosquera, cited the “compelling results” of foundational Dutch research on medical treatment of youth gender dysphoria. “[I]n all aspects assessed there is a very significant improvement compared to the untreated population, and the most striking finding is the suicide rate, which stands at 40 per cent in the untreated population, whereas in treated patients this rate drops to zero per cent,” he said. These dramatic claims are not supported by the scientific literature.

We have to talk

International | “It is no longer acceptable for academic events to be obstructed, or for professionals to be discredited or silenced, not on the basis of scientific argument, but under ideological or activist pressure. Science advances through rigorous examination of hypotheses, critical evaluation of practices, and openness to debate and disagreement.” That is from a communiqué issued by the French watchdog group the Little Mermaid, the Society for Evidence-based Gender Medicine, and the Clinical Advisory Network on Sex and Gender.

“We emphasize that gender medicine for adolescents raises major clinical, ethical, and scientific questions that are widely debated internationally. In this context, preventing discussion, restricting dialogue, or delegitimizing certain viewpoints ultimately undermines the quality of medical decision-making and, ultimately, the protection of young patients.”

Rogue or routine?

United Kingdom | An independent investigation of WellBN clinic, a Brighton primary care practice, has found that 78 children and adolescents—53 with “possible neurodevelopmental issues”—were potentially harmed by prescriptions of puberty blockers or cross-sex hormones. The patient safety report, commissioned by the National Health Service, said: “Puberty blockers and gender-enhancing medications were prescribed without a comprehensive bio-psychosocial assessment (in 22 cases without even face-to-face appointments having taken place), without essential baseline and ongoing investigations and in 75 cases without referrals to paediatric endocrinologists.”

Meanwhile, the British Medical Association (BMA), a doctors’ trade union widely cited for its criticism of the 2024 Cass Report, has eaten its words. The BMA council had dismissed Dr Cass’s findings as “unsubstantiated”. Now, after their own review, the BMA declared Dr Cass’s recommendations to be robust, although it still opposes the UK government’s puberty blocker ban.

London is about to host a two-day conference on “Rethinking Youth Gender Medicine”. The July 5-6 meeting is a collaboration between the Society for Evidence-based Gender Medicine and the Clinical Advisory Network on Sex and Gender.

Caution discriminates

France | The Lyon District Court has ordered health insurance funds to pay damages to four trans-identifying females, whose “gender-affirming” mastectomies the funds had declined to cover, Le Figaro reports.

“The health insurance funds had refused to reimburse the costs of mastectomy operations—which involve the removal of the mammary glands—on the grounds that the criteria for coverage under the long-term illness scheme had not been met, particularly in the case of one of the applicants, who was a minor at the time of the events,” the newspaper said. The funds had also concluded that trans medical interventions failed to meet the criteria for coverage as “an exceptional procedure”.

The judges in Lyon ruled that the requirement for medical documents violated these patients’ privacy. The court also found it discriminatory for the fund to insist on the agreement of an endocrinologist, surgeon and psychiatrist before a trans mastectomy, as well as a two-year psychiatric follow-up after the procedure. Under European human rights law, the funds could not make trans mastectomy more difficult to access than a mastectomy to treat breast cancer.

Systematically misleading

America | A 2025 study from the state of Utah has come under scrutiny during the June 3 US Senate committee hearing on paediatric gender medicine. The Utah study, which found hormonal treatment to be safe and effective, has been cited internationally to counter the more cautious recommendations of the UK Cass Review and the Gender Dysphoria Report from the US Department of Health and Human Services.

The Utah study has been miscast as a systematic review; were it indeed a systematic review, its “safe and effective” conclusion would be startling. That conclusion is at odds with multiple systematic reviews, independently commissioned in countries such as the UK, Sweden and Finland, all finding a lack of good evidence for puberty blockers and cross-sex hormones.

At the Senate committee hearing, the expert witness Dr Kurt Miceli of Do No Harm was sharply critical of the Utah study. He said it was “anything but” a gold-standard systematic review. The Utah researchers had not undertaken a synthesis of the evidence.

“When you do a systematic review, one of the key parts of it is to synthesise the evidence to look at not just the risk of bias, but the variation that’s within studies, to look at studies based on their study size, to analyse them fully,” Dr Miceli said. “None of that is done in the Utah report whatsoever.” He said 60 per cent of the clinical studies in the field had not been analysed, making the report “a complete data dump”.

Nor was there an assessment of the risk of bias in clinical practice guidelines. Instead, Dr Miceli said, the Utah study authors had accepted “as gospel” the guidelines from the World Professional Association for Transgender Health and the Endocrine Society. More here from Dr Miceli’s testimony.

Commentator Leor Sapir, writing for City Journal, noted a striking omission during the June 3 Senate committee proceedings. LGBTQ lobbyist Shannon Minter had not invoked the authority of the World Professional Association for Transgender Health (WPATH). Nor did any committee members sympathetic to “gender-affirming care” make reference to those supposed experts. Sapir said the likely reason was the string of scandals and damaging leaks involving WPATH. Meanwhile, Reduxx magazone reports that WPATH has disabled a feature allowing a search of health providers affiliated with the organisation.

The methodology of the Utah study has been checked and found wanting by the Society for Evidence-based Gender Medicine (SEGM). In March this year, unpersuaded by the Utah study, lawmakers in that state opted for caution and enacted a permanent ban on hormonal treatment of gender-distressed minors.

Less than systematic: Sapir discusses evidence-based medicine with SEGM’s Zhenya Abbruzzese

Pride in PR

Austria | The Transgender Centre Innsbruck has enjoyed uncritical media coverage as it pitches a Pride Month story in which judicious gender clinicians declare an “Access to care problem in Austria”, according to Faika El-Nagashi, a former Green politician and founder of the Athena Forum. With 800-900 patients, about a third of them under age 18, the Innsbruck clinic’s claims—that puberty blockers are reversible, hormones reduce depression and suicide, and treatment regret is only 1-3 per cent—were not challenged in reporting by the daily tabloid Heute nor by the public broadcaster ORF.

In Heute, parents were advised to be open and supportive when a child “asks whether they are living in the wrong body”. This media promotion brought a sharp rebuke from Daniela Karall, President of the Austrian Society for Paediatrics and Adolescent Medicine. Speaking to a Catholic-affiliated bioethics institute IMABE, Dr Karall said open debate had to include the risks and shortcomings of potentially lifelong medicalisation.

The author of the IMABE article wrote: “The term ‘sex reassignment’ inadequately describes the reality, emphasises Karall. Biologically, the sex remains the same; healthy organs are removed, and the surgically created equivalents—neovagina or neophallus—are prostheses that can never functionally match the original, not even in terms of sexual sensation.”

Judicial activism

New Zealand | The courts must resist the ideological capture seen in society’s other institutions and respect decisions by democratically elected ministers, according to Auckland barrister Deborah Chambers KC. The context for her opinion article was the judicial review launched by a lobby group, the Professional Association for Transgender Health Aotearoa Incorporated, against the November 2025 decision of NZ Health Minister Simeon Brown to ban new prescriptions of puberty blockers for gender-distressed minors. That ban is now on hold.

Writing in The New Zealand Herald, Ms Chambers said Mr Brown’s decision, which followed an evaluation of the evidence, “was a classic exercise of executive power delegated by Parliament to the Minister”. She acknowledged judicial review as a vital safeguard, but said it “has become an increasingly easy vehicle for well-resourced pressure groups to challenge and stall democratically made political decisions on largely procedural grounds.”

“While due process matters, when unelected judges intervene on technicalities in highly contested policy areas, a decision taken by elected politicians, with access to policy units, scientific advisers, cabinet processes and a public mandate, can be placed in indefinite limbo,” she said. “The risk is that persistent pressure groups may effectively capture the judicial review process.” The NZ Court of Appeal is scheduled to hear argument in the puberty blocker case next month.

Gender Gilead

Iceland | Eldur Smári Kristinsson, international liaison for LGB Alliance Iceland, calls his country “Gender Gilead”, a reference to its wholesale adoption of gender ideology. In an interview with journalist Julie Bindel, Kristinsson says the Gender Autonomy Act “led to an exponential surge in numbers of ‘trans children’, most of whom were young girls from upper-class backgrounds, many of them under the ‘neurodivergence’ umbrella”.

Bindel says: “The statistics bear him out; by 2025, 0.5 per cent of Icelandic children had changed their sex markers with the National Registry—approximately 13 times the per-capita rate of neighbouring Denmark.” Kristinsson, a gay man, has been targeted for expressing concerns about the medicalisation of children.

Into the fray

Australia | Clive Hamilton, who founded progressive think tank the Australia Institute and serves as professor of public ethics at Charles Sturt University, has joined the gender medicine debate as a principled sceptic. Writing independently on his Substack, Professor Hamilton surveys the Australian scene, noting the mistreatment of dissenting psychiatrists Dr Jillian Spencer and Dr Andrew Amos; the overweening influence of trans rights lobby ACON; the “highly partisan” role of the Australian Human Rights Commission as an “enforcer of gender ideology”; and the “craven” conduct of universities.

Meanwhile, in Queensland, the only Australian state to restrict hormonal treatment of gender-distressed minors, a tribunal has allowed a discrimination complaint against the ban to proceed as a quasi-class action. This originated with a patient at the Queensland Children’s Gender Service who was yet to receive puberty blockers. In June 2024, the clinic had 491 patients on its waiting list.

In Adelaide, the Coalition for Advancing Scientific Care will hold its second Gender Healthcare Summit on October 9-10. Speakers include psychotherapist Stella O’Malley, who founded Genspect.