Gender stronghold in revolt
Argentina's leader moves to suppress paediatric gender medicine
President Javier Milei of Argentina, the nation that claimed to be the first in the world to enshrine the concept of gender identity liberated from biology, has issued a decree to prohibit gender medicalisation of minors.
The February 6 decree invokes the United Nations Convention on the Rights of the Child and says that hormonal and surgical interventions to adapt the body to a self-perceived gender identity “can put [a minor’s] physical and mental integrity at risk and have irreversible effects.”
Last month, at the World Economic Forum in Davos, Mr Milei, a libertarian economist, denounced gender ideology as part of the woke corruption of liberalism and equality before the law, turning rights into privileges and requiring ever greater expansion of the coercive state and the penalising of dissent.
In an interview last week with LN+, Mr Milei said it was “an atrocity” to subject still-developing minors to irreversible gender medicine beyond their capacity to consent, “while filling their head with the idea that it is something other than what their biology says—well, that separating of gender from biology, it’s not cost-free.”
“I think they should let time run its course and let them make the decision [whether to be medicalised] as responsible adults,” he said.
Announcing the decree on February 5, Mr Milei’s presidential spokesman Manuel Adorni said: “Countries that pioneered gender reassignment, such as the United Kingdom, Sweden, Finland and recently the United States, are turning back and prohibiting minors from undergoing these processes, considering them irreversible and with devastating long-term consequences.” 1
It was not clear whether existing treatment of minors would continue unaffected in Argentina.
The decree, signed by Mr Milei and his cabinet, cites a technical report from Argentina’s National Directorate for Comprehensive Mental Health warning of “the lack of full knowledge regarding the long-term effects of hormone therapy.”
That unpublished report advises that minors not be allowed to undergo medical transition “since they have not yet completed their neurobiological and psychic maturity to fully understand the importance of the decision,” according to the decree.
Good start
The group Mothers of Girls and Adolescents with Rapid-onset Gender Dysphoria (MANADA Argentina), which formed in 2023 and represents 500-plus families, applauded President Milei’s intervention and urged him to take further steps.
MANADA, which was recognised for its human rights work by Argentina’s Senate last year, called for an immediate ban on the social transition of children in schools.
“Currently, in schools and in many psychological clinics, children are addressed by their [non-birth] name and self-perceived pronouns,” a spokeswoman for MANADA told GCN.
She said this “accelerates a process of transformation for which children are not mature enough.” Early social transition makes it more likely that a child’s discomfort in their birth sex will persist, exposing them to lifelong medicalisation, according to clinicians sceptical of the “gender-affirming” treatment approach.
Media coverage of Argentinian parents bewildered by their children—chiefly teenage girls with pre-existing problems—declaring an opposite-sex identity has highlighted possible triggers—
the dislocation of the Covid pandemic and lockdowns from 2020
the world-first Gender Identity Law of 2012
the influence of gender ideology on the comprehensive sexual education program (Educación Sexual Integral) in schools
social contagion through friendship groups and online platforms
In one news article last year, the mother of a 12-year-old girl, who had adopted a male identity, said the psychologist they saw asked her to support her daughter’s self-perception. Told of this new identity, the girl’s school changed its records immediately and began to treat her as a boy.
At first, told her daughter could attempt suicide if she were not accepted as a son, the mother went along with it. But she was uneasy and set out to inform herself; what she found out made her push back.
“I went to talk to the psychologist and the school management and asked them to stop affirming this self-perception because she was confused and emotionally unstable and we were consulting another psychologist,” the mother told the media outlet infobae.
“The only thing I achieved with this request for caution was that the school psychologist filed a criminal complaint against me for alleged ‘psychological abuse,’ invoking the Gender Identity Law.”
Psychiatrist María José Mancino, from the group Doctors for Life, welcomed the Milei decree as “very prudent,” the newspaper La Nación reported.
“There are already families and young people who regret that decision [to undergo medical transition], for whom there is no going back. No one listens to or supports the detransitioners,” Dr Mancino said.
“The public system does not provide for them and there are no free treatments for them [as detransitioners]. We are working on their cases so that they receive support.”
Promote, then deny
LGBTQ activists and clinicians have declared President Milei’s decree unconstitutional, threatened class action lawsuits and sought to minimise the extent of under-18 gender medicalisation amid much confusion.
An opinion article published by infobae yesterday summed up the situation this way—
“Half-truths and confusion about the Trans Law: what treatments have been applied to minors until now
“A multitude of voices came out to deny that gender transition surgeries and hormone treatments were being performed on young people under the age of 18, after the official announcement of their prohibition
“A strange eagerness to deny what they themselves promote: the official document that confirms it and the surgeon who recognises it”
Journalist Claudia Peiró, the author of the article, wrote: “Some of the lies were blatant, such as denying that the Gender Identity Law (or Trans Law), enacted in 2012, authorised these [hormonal and surgical] practices on minors.”2
“Or claiming that the Convention on the Rights of the Child (UN), to which Argentina adheres, contemplates the right to gender identity of a minor: not only is this false, but the word ‘gender’ does not even appear in that document.”
No surgery
Dr Adrián Helien, head of the Transgender Health Service at the public Durand Hospital in Buenos Aires, told La Nación that “no one under the age of 18 has surgery—there was only one case, which was done by court order.”3
“But there are international protocols that we follow, and the consensus is that surgical treatments are not carried out before that age.” The latest protocols from the World Professional Association for Transgender Health (WPATH) eliminated minimum ages for all medical interventions but the most risky surgery.
In an interview with Urbana Play, surgeon and urologist Javier Belinky, a WPATH board member who until recently was in charge of gender-affirming surgery at Durand Hospital, disagreed with presenter María O’Donnell’s suggestion that such hormonal and surgical changes to the body were “quite drastic.” He justified these interventions as a response to “very strong” distress in patients.
He said he had performed trans surgery on “only 16” minors since 2005; he did not specify whether these were mastectomies or genital surgeries.
“It is not as if, [of] all the patients under 18 who ask us for surgery… we are going to operate on them before they turn 18,” he said.
“There is a whole evaluation process and we select very carefully the cases that we are going to end up operating on under the age of 18. They are highly selected cases treated by a multidisciplinary team.”
Dr Belinky said the government’s prohibition on paediatric gender medicine would result in “people who self-harm because they feel unwell, people who are depressed, people who are going to resort to perhaps clandestine surgery … or who are going to resort to clandestine hormone therapies with serious health risks.”
He said there was “much more demand” for treatment—for patients with “fluid genders”—but this was not driven by fashion.
However, he conceded that a high proportion of those who identified as non-binary in childhood would not persist in this identity.
Dr Belinky’s practice offers surgery to masculinise or feminise patients but also “options for people with non-binary identities.”
Among the questions on his FAQ page is: “Can one ejaculate after a phalloplasty [the creation of a pseudo-penis for a female]?” The answer: “No, you can create the best phallic structure and the best urethra but you can't generate glands that allow seminal emission after orgasm.”
Video: An Instagram reel from the Argentina’s province of Santa Fe features young females celebrating mastectomies at a pool party. The post is from a transmale and non-binary association with a link to the local government of Rosario
Sorry, no data
Argentina’s Ministry of Health told La Nación it had no data on the gender treatment of minors owing to the country’s decentralised health system. A ministry guide to organisations that offer services to minors identifying as trans or non-binary across the country’s provinces runs to 44 pages.
In La Nación, gender clinician Dr Helien claimed that cross-sex hormones were not given before age 16.
However, a guide from Argentina’s Ministry of Health—issued eight months before Mr Milei’s election in November 2023—advises that cross-sex hormones, meant to be taken lifelong, can be prescribed at age 14.
This ministry “consensus document” on “Pubertal Inhibition and Induction for Trans, Transvestite and Non-binary Children and Adolescents”—which lists Dr Helien among members of the review panel—recommends puberty blockers at the onset of puberty, meaning as young as ages 9-13. Data suggests the vast majority begun on blockers go on to cross-sex hormones.
Building happiness
Last week, LGBTQ activists and clinicians opposing the new decree joined a protest meeting convened by the Committee for Women and Diversity in the chamber of deputies, the lower house of Argentina’s congress.
“Mileism proposes that they would not interfere with what each person wants to do in bed, which is to rethink the concept of the private, but not the public, and this is a huge conceptual step backwards, because what we want is for each person to be able to live with dignity, with freedom, building their own happiness in bed, at school, at university, at work, in the street, in the media and wherever,” said the committee chair, psychologist Mónica Macha of the centre-left Frente de Todos bloc.
Dora Barrancos, a feminist and advisor to Argentina’s former Frente de Todos government, denounced what she described as a “planetary, fascist anti-rights crusade, which has found a focal point.”
Adjusting bodies
Mr Milei’s executive branch decree seeks to amend Argentina’s historic 2012 Gender Identity Law so that only adults can access hormonal and surgical interventions. That 2012 law was enacted during the presidency of the Left-Peronist Cristina Fernández de Kirchner, who was supported by El Frente de Todos.
The Gender Identity Law promises adults “free development of their person according to their gender identity” and subsidised access to “total and partial surgical interventions and/or comprehensive hormonal treatments to adjust their bodies, including their genitalia, to their self-perceived gender identity, without requiring any judicial or administrative authorisation.”
For minors, there is an “informed consent” process relying on “the evolving capacities and best interests of the child” under the Convention on the Rights of the Child, with a judge empowered to grant access to treatment if parental approval “is denied or impossible to obtain.”
In 2015, former president Fernández de Kirchner issued a decree to enumerate the trans surgeries available under the Gender Identity Law—
“Augmentation mammoplasty, mastectomy, augmentation gluteoplasty, orchiectomy, penectomy, vaginoplasty, clitoroplasty, vulvoplasty, adnexohysterectomy, vaginectomy, metoidioplasty, scrotoplasty and phalloplasty with penile prosthesis, the present list being merely illustrative and not exhaustive.”
The March 2023 consensus guide to puberty blockers and cross-sex hormones for children and adolescents issued by Argentina’s Ministry of Health tells clinicians that, “in all consultations, it is essential to—
“Take children and adolescents at their word without falling into questions or speculations such as: ‘Isn’t she too young?’, ‘Isn’t he too young?’, ‘Isn’t this the mother’s demand or a projection of her desires?’, ‘Isn’t this a disorder of the psychic structure?’
“Not invalidate or recommend ‘slowing down’ gender expressions of children or adolescents with the argument of ‘waiting for this to pass’.”
The guide notes effects of puberty blockers including atrophy of breast tissue and lack of menstruation for “persons born with ovaries, uterus and vagina,” while “persons born with a penis and testicles” can expect shrinkage or lack of growth of the penis.
The document acknowledges a lack of data to determine how long adolescents can have their natural sex hormones suppressed by blockers “without this posing a significant risk to bone health.”
It recognises the absence of long-term studies to determine whether hormone suppression interferes with critical windows for development in the adolescent brain, yet relies on dated Dutch studies to claim that puberty blockers are “totally reversible.”
The ministry guide notes that recent guidelines from the World Professional Association for Transgender Health (WPATH, 2022) and the Royal Children’s Hospital Melbourne (2018) have abandoned the view that minors younger than 16 should not be given cross-sex hormones.
The guide says “there are limited studies on young people who have started hormone treatment before the age of 14.”
“Although the long-term effects of hormone treatment initiated in adolescence are not fully known, the possible negative [mental] health consequences if treatment is delayed must also be considered,” says the guide, citing the low-quality WPATH document.4
The Argentinian ministry’s guide recommends cross-sex hormones from age 14.
“In those [males] who have completed their endogenous pubertal development, the use of oestrogens [as cross-sex hormones], with or without the association of anti-androgens, will produce a significant decrease in sperm quantity and quality, and may eventually cause definitive sterility,” the guide says.
Using adult data, the guide says the risks of oestrogen treatment include thromboembolism, hypertension, type 2 diabetes and breast cancer.
As for testosterone, the guide lists the key risks as blood thickening (polycythemia), destabilisation of psychiatric conditions such as bipolar disorder or psychosis, cardiovascular disease, hypertension, type 2 diabetes, as well as cancer of the breast, cervix, ovaries and uterus.
Long-term ignorance
On the evidence base for these hormonal treatments with minors, the guide says—
“Currently there is little available evidence of the effects that pubertal inhibition and/or long-term hormone treatment with sex steroids could have on [trans and gender-diverse youth] over the long term,” says the guide, which suggests that longitudinal studies be undertaken.
“Although puberty-inhibiting medication is reversible and should not itself affect long-term fertility, it is unlikely that adolescents will wish to discontinue its use in order to undergo fertility preservation interventions before commencing [cross-sex] hormone treatment,” the guide says.
“It is therefore necessary that counselling [on the risk of infertility] be carried out before the commencement of any hormonal intervention.”
The contents of the ministry guide are attributed to paediatric endocrinologist and gender clinician Dr María Verónica Fernández Mentaberry. The review panel for the document includes representatives of medical associations, hospitals and gender clinics, as well as gender and diversity activists.
In the LT+ interview last week, Mr Milei offered his personal opinion that the state should not have to finance a citizen’s bodily modifications in pursuit of a self-declared identity.
Addressing the interviewer, journalist Esteban Trebucq, Mr Milei said: “You, for example, do you want to self-identify as a seal and become a seal? I have no problem with that. What I think is wrong is that you think I have to pay the bill for that, because then it’s not a right—it’s a privilege.”
The group MANADA argues that gender medicine interventions for adults—not only for minors—are “still at the experimental stage” and as such should not be subsidised at all under the Compulsory Medical Program (Programa Médico Obligatorio).
Before any hormonal or medical treatment, adults should undergo “an exhaustive psychological and clinical study” to determine whether they are able to give fully informed consent, MANADA told GCN.
Intervention should be delayed if the adult patient has developmental problems or autism, ADHD or borderline personality disorder.
Internationally there has been increasing concern about gender medicalisation up to the age of 25, when the adolescent brain reaches maturity.
Those countries have imposed restrictions, not outright bans, on paediatric gender medicine. The common rationale is the absence of good quality evidence and concern about iatrogenic harm.
Advocates for the gender-affirming model internationally have worked behind the scenes in policy to streamline access to medical treatment for minors but often play down the extent of this medicalisation when it comes under public scrutiny.
It is not clear if he is referring to a double mastectomy or genital surgery.
The three relevant international treatment guidelines—from WPATH, the Endocrine Society and RCH Melbourne—were all judged to be of low quality and not recommended for use after an independent evaluation commissioned by England’s historic Cass review.
I reference a recent paper from ‘Australas Psychiatry’ of March 2024 titled:
‘The gender-affirming model of care is incompatible with competent, ethical medical practice’
In the absence of models of the phenomenology and psychopathology of gender diversity, it is impossible to meaningfully judge what proportion of cases involves pathology or assess the role of pathology in individual patients.
Unquestioning gender-affirming care is therefore unable to exclude the possibility that it is reinforcing the pathologies of some, most, or all of its patients. This is unethical, and it is the responsibility of psychiatrists to ensure that no patients are harmed by this dangerous model of care.
I love Javier Milei! A sensible leader pronouncing normality. Like the President Trump. Doctors who mutilate and poison children should be barred from medical practice and prosecuted.