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NYT scoop; probe the Dutch protocol; backdoor blockers for Brits; Portugal's chance; Texas at war with gender medicine; biggest insurance scam ever; Aussie petition; unmasking Chile's trans project
GCN in brief
Missing data
America | Politically inconvenient results from a major US study of puberty blockers have not been published because the lead researcher, Dr Johanna Olson-Kennedy of the Childrenโs Hospital Los Angeles, says she is worried the data showing no improvement could be โweaponisedโ and used in litigation by opponents of โgender-affirming care.โ As part of a multi-clinic study with almost $10 million in US government funding, 95 minors with an average age of 11 were started on puberty blockers in 2015 and tracked for two years.
According to an October 23 news report in The New York Times, Dr Olson-Kennedy sought to explain the lack of improved mental health by claiming the children were โin really good shape when they come in, and theyโre in really good shape after two years.โ However, in 2020, Dr Olson-Kennedy and colleagues had reported that 25 per cent of the study participants were depressed or suicidal before treatment.
There are parallels with the 2011-14 UK Tavistock study of early puberty suppression where researchers delayed publication of discouraging results for several years. The New York Times quoted gender care reviewer Dr Hilary Cass, in paraphrase, as saying โthat the delays from the American and British research groups had led the public to believe that puberty blockers improved mental health, even though scant evidence backed up that conclusion.โ
On Twitter, UK author JK Rowling summed up the Olson-Kennedy position as, โWe must not publish a study that says weโre harming children because people who say weโre harming children will use the study as evidence that weโre harming children, which might make it difficult for us to continue harming children.โ In the US Congress, Republicans have said they will investigate the withholding of the puberty blocker data. Republican Senator Marco Rubio has urged an investigation by the funding body itself, the National Institutes of Health (NIH). He also asked the NIH to clarify the mental health of the children before puberty suppression, given the contradictory claims by Dr Olson-Kennedy.
Probing the protocol
Netherlands | The Dutch Health Council, an independent scientific advisory body, has confirmed that in 2025 it will โmap what is scientifically known about the (long-term) consequences of puberty inhibitors and gender-affirming hormone treatments on physical and mental health.โ Earlier this year, the Netherlands parliament approved two motions seeking research into medicalised gender change for minors and advice from the Health Council on the medico-legal implications. The โDutch protocolโ for โjuvenile transsexualsโ led to international adoption of puberty blockers for gender distress. In a webpage statement, the Health Council notes that it has also been asked to compare the Dutch model โwith the approach in other countries and with care standards and applicable laws and regulations.โ
The statement acknowledges โincreasing criticism of the use of puberty inhibitors and hormones,โ yet appears to prejudge key issues in contention, including the purpose of puberty suppression and the adequacy of diagnostic assessment. In June, at the Paris conference of the Society for Evidence-based Gender Medicine and the watchdog group The Little Mermaid, Dutch philosopher Dr Jilles Smids expressed some optimism about the project assigned to the Dutch council because he felt such โneutralโ health authorities were more likely than gender clinicians to confirm the weakness of the evidence base and bring about a timely shift to greater caution in treatment policy.
Offshore blockers
United Kingdom | A company founded by Susie Green, the ex-chief of the UK transgender activist charity Mermaids, claims to offer a โlegal routeโ for access to puberty blockers, which have been banned in the UK following the 2020-24 Cass review. Her company Anne Trans Healthcare states that blockers can be prescribed for UK children by doctors outside the UK and picked up from an โEU destination,โ The Times says.
Meanwhile, a new report reveals that the Charity Commission took issue with a Mermaidsโ claim that puberty blockers were โan internationally recognised safe, reversible healthcare optionโ. Mermaids was instructed to give weight to Dr Cassโs findings. Although that targeted claim was removed, the group Transgender Trend notes that the Mermaids website elsewhere makes the equivalent unsupported statement that, โBlockers simply give time for [children] to reflect, they can stop at any point and a puberty typically associated with the gender they were assigned at birth will resume.โ
A petition to stop a Cass-linked clinical trial of puberty blockers has attracted more than 47,000 signatures. Addressed to UK Prime Minister Keir Starmer and Health Secretary Wes Streeting, the petition says: โThese [puberty blocker] drugs are designed to pause and alter the physical changes of puberty, permanently affecting the child's development and causing irreversible harm. This is completely unjustifiable and unethical.โ
Video: LGB Alliance co-founder Kate Harris talks to US gender clinic whistleblower Jamie Reed
Dodge a bullet
Portugal | Every week in Portugal, where Genspect held its recent Bigger Picture conference, 11 people change their legal name and gender, and two publicly funded trans surgeries are carried out, yet the closure of the London-based Tavistock gender clinic and the Cass review โwent completely unnoticed,โ according to journalist Marisa Antunes writing in the Portuguese news magazine Sรกbado. In an interview published on October 13, she asked Genspect founder Stella OโMalleyโs advice for Portugalโs health authorities.
OโMalley said: โThe Portuguese government, if it is wise, can learn from the mistakes made in other countries in relation to gender identity issues and thus avoid those same mistakes happening in Portugal, with terrible consequences for young people. Just stop, question and think for a moment... Who were the pioneers of paediatric transition medicine and what are they doing now?
โCountries like Sweden and Finland are putting the brakes on the affirmative approach to gender medicine... [Portugal] should look at what happened in England, where the largest-ever research study on gender medicine (the Cass review) took four years to be carried out. It is independent research and the conclusion was quite clearโthere is no scientific evidence to support this kind of radical intervention with children and young people.
โThis cannot continue to be done to children and young people, who are too vulnerable to make these kinds of decisions. If the Portuguese government is aware, it can look to America and the polarisation that exists there, and all the devastation caused by the affirmative [treatment] approach.โ A full English translation of the article is here. Antunes sketches the Portuguese context here.
Wrong direction
Canada | The National Post newspaper has run a lengthy feature article on the plight of detransitioners in Canada. One interviewee, Sarah, who suffers from nerve damage after a mastectomy, โwas asked, when she reached out to her old gender clinic, whether she felt transitioning to identify as male was a necessary step in her gender journey. โI almost laughed,โ she said. โI thought that was an insane question to ask. I said no, that if anything I should have been mandatorily put into therapy. But therapists are scared to even ask questions because theyโre afraid of losing their licence if somebody gets offended and itโs deemed conversion therapyโ.โ
Enforcement phase
America | A Texas gender clinician, Dr May C Lau, is being prosecuted under state consumer protection law for allegedly using a false diagnosis of โendocrine disorder, unspecifiedโ so that puberty blockers for a female-identifying 15-year-old boy would be covered by medical insurance. Anecdote suggests this practice is widespread in the US. The Texas governmentโs action against Dr Lau, who is medical director of the Adolescent and Young Adult clinic at Childrenโs Medical Center Dallas, is also historic as the first enforcement of a 2023 state legislative ban on puberty blockers, cross-sex hormones and trans surgery for minors.
Dr Lau allegedly prescribed cross-sex testosterone to 21 girls, the youngest being age 14. Most were given testosterone cypionate, which is โnot indicated for useโ with females, according to the regulatory FDA. In medical records, several of Dr Lauโs patients were falsely noted as male.
In the case of the 15-year-old given puberty blockers, Dr Lau is accused of โdeceptively misleadingโ pharmacies, insurance firms and/or patients by falsifying medical records, prescriptions and billing records to conceal the true nature of the treatment. The Texas petition, filed on October 17 in the District Court of Collin County, notes trans activist advice that gender clinicians cite โendocrine disorderโ, rather than diagnoses related to gender distress, which were often rejected by insurers.1
The petition says: โGender dysphoria is not an endocrine disorderโฆ Children normally enter puberty reflecting their biological sex. There is no disorder at all. Rather, the disorder results when a physician intervenes in a childโs natural puberty to induce, through puberty blockers and cross-sex hormones, a state of puberty naturally occurring in the opposite sex. Such [a] physician causes a disorder rather than treats one, by introducing [a] supraphysiological dose of a cross-sex hormone to force a childโs body (a biological reality) to fit that childโs gender identity (a mental construct).โ
In a separate legal action, Texas is leading a 17-state challenge to a rule change by the US Department of Health and Human Services adding gender dysphoria to the list of disabilities protected from discrimination.
Texas surgeon Dr Eithan Haim, who is being prosecuted by the Biden Administrationโs Department of Justice after he exposed covert gender medicalisation at Texas Childrenโs Hospital, has highlighted the insurance focus of โgender-affirming care.โ Citing court documents revealing the politicised inner workings of the World Professional Association for Transgender Health (WPATH), Dr Haim said WPATHโs current treatment guideline, known as SOC-8, had been โcrafted not to promote the health of their patients but to ensure reliable insurance coverage and defend that windfall in cashflow from legal challenges.โ
Drawing on the database of the medical watchdog group Do No Harm, he tweeted that New Yorkโs Mount Sinai Medical Center had generated $8 million in charges from 100 surgeries on minors, roughly $80,000 per patient. โBy misrepresenting the evidence in SOC-8, WPATH and the federal government ensured the most profit could be made by those who engineered the fraud in the first place,โ Dr Haim says. โWhile endangering the lives of countless patients, they pulled off one of the greatest insurance scams probably in the history of insurance scams.โ
Top End petition
Australia | A petition in Australiaโs Northern Territory urges the government to hold a Cass-style review of the gender medicalisation of minors and suspend โall medical and surgical transitioning treatments for childrenโ in the territory. The petition, with 463 signatures, was tabled on October 17. The centre-right Country Liberal Party won office in the territory in August. The Public Accounts Committee is to decide whether or not the petition should be referred to the Legislative Assembly for debate, according to the office of Health Minister Steve Edgington.
The neighbouring northern state of Queensland also has a new centre-right government under Liberal National Party leader David Crisafulli following an October 26 election. The former centre-left Labor administration had planned an expansion of gender-affirming medicine for minors following an evaluation of the Queensland Childrenโs Gender Service. That evaluation was ideological and flawed, according to three psychiatrists critical of the gender-affirming treatment model. Their analysis, published by the journal Australasian Psychiatry, argues that the government-commissioned evaluation reveals โa disturbing inclination to protect the reputation of a [gender] service rather than to protect the health and wellbeing of Queenslandโs gender-diverse children and the parents that are responsible for them.โ
Sleight of hand
Chile | The Chilean governmentโs Program for Support of Gender Identity (Programa de Acompaรฑamiento a la Identidad de Gรฉnero, PAIG) and its Trans Health Program (Programa de Salud Trans, PST) are based on documents offering โvirtually no evidence to support the scientific validity of [gender-affirming] treatments,โ according to analysis by Chilean psychologist Juan Pablo Rojas-Saffie of Finis Terrae University. Both these government programs are under investigation by a parliamentary committee in Chile following breakthrough coverage of the gender medicine debateโincluding the Cass reportโby journalist Sabine Drysdale on the news site BรญoBรญoChile.
In August, Chilean Health Minister Ximena Aguilera appeared before the Committee for Family, Children and Adolescents. Ms Aguilera, who said 98 per cent of the children referred to PAIG were between age 10 and 17, claimed there was โno state programme that contemplates the purchase of hormones for children with gender dysphoria,โ but said doctors could exercise their professional freedom to prescribe these treatments.
After inquiries were made, it was reported that about 600 of the 1,900 children in PAIG were reportedly on puberty blockers. Last month, the trans activist-turned-detransitioner Nicolรกs Raveau appeared before the committee and asked, โWhy does the Ministry of Health lie when they say that they have no program to offer hormones to minors (programa para hormonar a menores de edad), when from the age of 10 they expressly allow it? Is it because there would not be [state] funding?โ PAIG is open to minors aged 3-17 and PST from age 10.
In his analysis published this month, Dr Rojas-Saffie says: โA comprehensive reading of the PAIG and PST documents shows that both programs contemplate and promote the hormone treatment of children who identify themselves as transgender or gender non-conformingโฆ Taken together, both the PAIG and the PST suggest that childrenโs access to hormone treatments is beneficial and of low risk. However, this contrasts with the conclusions of the Cass report, which state that hormone treatments do not have benefits proven by quality evidence and that their risks are not sufficiently well known.โ
Dr Rojas-Saffie argues that Chileโs health authorities should offer an alternative to the gender-affirming treatment model, such as an exploratory or holistic approach creating โspace for children to grow in self-awareness and maturity without the need for social or hormonal transition. This is the approach that comes closest to the recommendation made by Dr Cass, in the sense of reducing anxiety through a real process of psychotherapy for these young people, and not through more invasive interventions such as social or hormonal transition.โ
In the newspaper La Tercera earlier this month, the prominent Chilean gender clinician and psychologist Dr Claudio Martรญnez dismissed the Cass review as biased and said parents who resisted treatment were driven by fears about their childโs novel identityโ โIt has to do with losing everything, from their name to their relationship with their son or daughter,โ he says. On October 19 La Tercera ran a letter in reply, arguing that parental resistance to medicalisation represents caution, not fear. โWhat if we were to apply blockers and/or cross-sex hormones to our children when this sudden self-declaration of being โborn in the wrong bodyโ was just a stage of adolescence when one seeks acceptance by oneโs peers?,โ wrote Yazmin Altamirano, a member of the parentsโ group Kairรณs.
Transing the gay away
America | Commentator Andrew Sullivan, a key figure in the achievement of same-sex marriage in the US, has denounced the gender medicine lobby for interfering in natural puberty, robbing children of future capacity for sexual pleasure and exposing them to sterilisation. Data suggests that some significant proportion of these children would grow up to be LGB adults in healthy bodies were they not medicalised as โtransโ. โI remember very well how all my gender insecurities as a gay kid vanished after puberty,โ Sullivan writes at his Weekly Dish Substack.
โSo, I urge any gay man or lesbian who, as a child or teen, was barred from this basic human right [of puberty], to be brave and start the lawsuits. Itโs the only way. No gay men or lesbians will come to your aid. Kamala Harris and the gay groups sure wonโt. โLGBTQIA+โ billionaires will sacrifice any number of gay kids if it means not being called โtransphobicโ at a dinner party.โ A writer from the group Democrats for an Informed Approach to Gender welcomed Sullivanโs post but took issue with his apparent belief that there remains a category of children who are โactually trans.โ
โWe must not publish a study that says weโre harming children because people who say weโre harming children will use the study as evidence that weโre harming children, which might make it difficult for us to continue harming children.โ
Pure Gold by JK Rowling
The number of European countries prohibiting the use of puberty blockers and cross sex hormones in children is ever expanding and currently includes: England, Denmark, Sweden, the United Kingdom and Germany.
These are nations have highly-respected standards of medical expertise and the consensus for their caution is cited along the lines of:
โThe risks of puberty blockers and gender-affirming hormone treatments for persons younger than 18 years is currently outweigh the potential benefits of their useโ
Meanwhile we are assured by the relevant experts in Australia that the expanding caution in Europe is inappropriate.
Where has there ever been such a schism in medical opinion:
On the one hand a cautious and conservative approach and on the other Puberty Blockers, Cross Sex Hormones and irreversible mutilating surgery.
Both parties cannot be correct and someday there will be an almighty pox on the one that erred.