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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

Photo by Claudio Schwarz on Unsplash

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 Children’s Hospital Los Angeles, says she is worried the data showing no improvement could be “weaponised” and used in litigation by opponents of “gender-affirming care.” 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 “in really good shape when they come in, and they’re in really good shape after two years.” 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 “that 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.”

On Twitter, UK author JK Rowling summed up the Olson-Kennedy position as, “We must not publish a study that says we’re harming children because people who say we’re harming children will use the study as evidence that we’re harming children, which might make it difficult for us to continue harming children.” 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 “map what is scientifically known about the (long-term) consequences of puberty inhibitors and gender-affirming hormone treatments on physical and mental health.” 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 “Dutch protocol” for “juvenile transsexuals” 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 “with the approach in other countries and with care standards and applicable laws and regulations.”

The statement acknowledges “increasing criticism of the use of puberty inhibitors and hormones,” 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 “neutral” 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 “legal route” 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 “EU destination,” The Times says.

Meanwhile, a new report reveals that the Charity Commission took issue with a Mermaids’ claim that puberty blockers were “an internationally recognised safe, reversible healthcare option”. Mermaids was instructed to give weight to Dr Cass’s findings. Although that targeted claim was removed, the group Transgender Trend notes that the Mermaids website elsewhere makes the equivalent unsupported statement that, “Blockers 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.”

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: “These [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.”

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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 “went completely unnoticed,” according to journalist Marisa Antunes writing in the Portuguese news magazine Sábado. In an interview published on October 13, she asked Genspect founder Stella O’Malley’s advice for Portugal’s health authorities.

O’Malley said: “The 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?

“Countries 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 clear—there is no scientific evidence to support this kind of radical intervention with children and young people.

“This 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.” 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, “was 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. ‘I almost laughed,’ she said. ‘I 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 they’re afraid of losing their licence if somebody gets offended and it’s deemed conversion therapy’.”

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 “endocrine disorder, unspecified” 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 government’s action against Dr Lau, who is medical director of the Adolescent and Young Adult clinic at Children’s 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 “not indicated for use” with females, according to the regulatory FDA. In medical records, several of Dr Lau’s patients were falsely noted as male.

In the case of the 15-year-old given puberty blockers, Dr Lau is accused of “deceptively misleading” 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 “endocrine disorder”, rather than diagnoses related to gender distress, which were often rejected by insurers.¹

The petition says: “Gender dysphoria is not an endocrine disorder… Children normally enter puberty reflecting their biological sex. There is no disorder at all. Rather, the disorder results when a physician intervenes in a child’s 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 child’s body (a biological reality) to fit that child’s gender identity (a mental construct).”

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 Administration’s Department of Justice after he exposed covert gender medicalisation at Texas Children’s Hospital, has highlighted the insurance focus of “gender-affirming care.” Citing court documents revealing the politicised inner workings of the World Professional Association for Transgender Health (WPATH), Dr Haim said WPATH’s current treatment guideline, known as SOC-8, had been “crafted not to promote the health of their patients but to ensure reliable insurance coverage and defend that windfall in cashflow from legal challenges.”

Drawing on the database of the medical watchdog group Do No Harm, he tweeted that New York’s Mount Sinai Medical Center had generated $8 million in charges from 100 surgeries on minors, roughly $80,000 per patient. “By 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,” Dr Haim says. “While endangering the lives of countless patients, they pulled off one of the greatest insurance scams probably in the history of insurance scams.”

Top End petition

Australia | A petition in Australia’s Northern Territory urges the government to hold a Cass-style review of the gender medicalisation of minors and suspend “all medical and surgical transitioning treatments for children” 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 Children’s 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 “a disturbing inclination to protect the reputation of a [gender] service rather than to protect the health and wellbeing of Queensland’s gender-diverse children and the parents that are responsible for them.”

Sleight of hand

Chile | The Chilean government’s Program for Support of Gender Identity (Programa de Acompañamiento a la Identidad de Género, PAIG) and its Trans Health Program (Programa de Salud Trans, PST) are based on documents offering “virtually no evidence to support the scientific validity of [gender-affirming] treatments,” 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 debate—including the Cass report—by journalist Sabine Drysdale on the news site BíoBíoChile.

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 “no state programme that contemplates the purchase of hormones for children with gender dysphoria,” 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 Nicolás Raveau appeared before the committee and asked, “Why 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?” PAIG is open to minors aged 3-17 and PST from age 10.

In his analysis published this month, Dr Rojas-Saffie says: “A 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-conforming… Taken together, both the PAIG and the PST suggest that children’s 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.”

Dr Rojas-Saffie argues that Chile’s health authorities should offer an alternative to the gender-affirming treatment model, such as an exploratory or holistic approach creating “space 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.”

In the newspaper La Tercera earlier this month, the prominent Chilean gender clinician and psychologist Dr Claudio Martínez dismissed the Cass review as biased and said parents who resisted treatment were driven by fears about their child’s novel identity— “It has to do with losing everything, from their name to their relationship with their son or daughter,” he says. On October 19 La Tercera ran a letter in reply, arguing that parental resistance to medicalisation represents caution, not fear. “What if we were to apply blockers and/or cross-sex hormones to our children when this sudden self-declaration of being ‘born in the wrong body’ was just a stage of adolescence when one seeks acceptance by one’s peers?,” wrote Yazmin Altamirano, a member of the parents’ group Kairós.

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 “trans”. “I remember very well how all my gender insecurities as a gay kid vanished after puberty,” Sullivan writes at his Weekly Dish Substack.

“So, 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. It’s the only way. No gay men or lesbians will come to your aid. Kamala Harris and the gay groups sure won’t. ‘LGBTQIA+’ billionaires will sacrifice any number of gay kids if it means not being called ‘transphobic’ at a dinner party.” A writer from the group Democrats for an Informed Approach to Gender welcomed Sullivan’s post but took issue with his apparent belief that there remains a category of children who are “actually trans.”

1. In Australia, the false diagnosis of “testicular disorder” is used to justify taxpayer-funded testosterone as a cross-sex hormone for females seeking to masculinise their bodies.