Laura's test case for Latin America

Plus: Momentum against blocker trial; Florida sues Big Gender; anti-data affirmationists in Italy; an NZ tantrum; a blind alley in South Africa; Belgian clinic faces lawsuit; WPATH just winging it

Photo by Flavia Carpio on Unsplash

GCN global briefs

Rush to diagnosis

Colombia | A young woman whose history of sexual abuse, depression, anxiety, self-harm and an eating disorder was allegedly ignored by gender clinicians has launched a test case against one of Latin America’s most famous private hospitals. Known as Laura, she was given testosterone at 15, followed by puberty blockers and a double mastectomy; she has since detransitioned.

She had reportedly been sexually abused from the age of five to seven by the family’s domestic help, and kept silent about it for almost ten years. She feared growing up as a woman, then encountered transgender material online and felt she wanted to become a man. “If you are uncomfortable with your period, if you prefer wearing jeans to skirts, if you don’t wear make-up—they said [on YouTube] that all of these were reasons to become a trans man,” Laura told the Colombian news magazine Semana. “In my fear of being a woman, which I had had since childhood, and my teenage confusion, all of this made sense. I started to think I was a boy.”

In 2017, her worried parents took her to the Valle de Lili hospital in Cali, Colombia, which bills itself as the best in the country. At that time, its gender clinic was just being established and Laura’s case was to be the “success story to launch” the new unit, according to the pro-family New Democracy Foundation, which filed her multi-million-peso medical malpractice action on November 7 in the civil circuit court of Cali.

The case argues that her gender dysphoria diagnosis was rushed, her trauma and co-morbidities were ignored, she was given testosterone younger than allowed by treatment standards, the use of puberty blockers to suppress her menstruation was irregular, and she lacked the emotional and cognitive maturity to consent to irreversible treatment.

“The clinic confused a symptom (bodily dissatisfaction typical of trauma) with a diagnosis of dysphoria,” New Democracy said. “Supramaximal doses of testosterone and ‘masculinisation of the chest’ caused real physical pathologies where none existed before. The treatment Laura underwent caused permanent risks to her fertility, breastfeeding, reproductive health, and mental health.” Her case relies on expert reports from a Chilean psychologist, a Swedish paediatric endocrinologist and two American physicians, one a psychiatrist and the other a specialist in women’s reproductive health.

It is said to be Colombia’s first detransitioner lawsuit and a potential precedent for Latin America. Laura “hopes that her story will prevent further harm to other minors,” New Democracy said. The hospital said it could not comment on individual patients, but insisted that “all interventions and procedures performed at the institution are based on scientific evidence and have the respective informed consent,” Semana reported.

Blocker repulsion

United Kingdom | The UK clinical trial of puberty blockers, recommended by the Cass review and scheduled to begin in January, is coming under intense legal, political and clinical pressure. A solicitor’s letter to the regulatory agencies that signed off on the PATHWAYS trial has threatened court action if the experiment is not stopped. The potential litigants are parents’ association the Bayswater Support Group, psychotherapist James Esses of Thoughtful Therapists and Tavistock clinic detransitioner Keira Bell.

Their lawyer’s letter, seeking a response by December 19, argues that the trial—which is to recruit more than 200 children younger than 16—is unethical and unlawful. The letter notes the unusual nature of the condition under treatment; gender incongruence being “neither a physical disease or illness, nor a mental health disorder”. “The trial therefore proposes to provide a pharmacological intervention which prevents a physiologically normal process in order to treat a presentation which involves neither physical nor mental ill-health. This is not medicine as it is usually understood.”

The letter contends that the flawed design of the trial will not deliver clear results, saying “the trial outcomes will be affected by, among others: (i) bias engendered by the lack of a blind control group such that any placebo effect will be attributed to the administration of the treatment; (ii) the confounding factor of psychosocial intervention being provided alongside the hormone treatment, as well as the impact of other factors such as social transition, particularly where the primary outcome expected relates to self-reports by children on emotional wellbeing; and (iii) the likelihood that the administration of treatment itself may change the trajectory of gender identity development in children”.

In defence of the trial, the centre-left Labour government has invoked cross-party support for the Cass review, and the Department of Health insists the trial proposal passed “extremely rigorous safety checks”, and includes “multiple safeguards in place to protect young people’s wellbeing, including clinical and parental approval”.

In parliament, the prominent Conservative MP Claire Coutinho put a pointed question to Labour Education Secretary Bridget Phillipson, asking if she believed “that an eight-year-old child with autism can consent to a medical pathway that will leave them infertile and without sexual function for the rest of their life? If not, will she tell the Health Secretary [Wes Streeting] herself to stop this puberty blocker experiment, which will biologically castrate children?”.

In an interview, Streeting confessed he was “deeply uncomfortable” with the idea of “medication that delays, or indeed stops, a natural part of our human development, which is puberty”. However, he said he was “trying really hard as a politician not to interfere or block clinical advice [favouring the trial] by people who are, frankly, far more qualified than me”.

Streeting has been sent a letter of opposition to the trial from 20 named clinical psychologists, echoing his discomfort with the idea of suppressing a child’s natural puberty. “Leaving behind the heated ideology which to date has interfered with debate, the reality is that [a] previously suppressed profound lack of consensus remains within the clinical community and that the trial should therefore not proceed,” the psychologists’ letter said.

The group Genspect had ten questions for Streeting, including: “Childhood gender non-conformity is strongly associated with same-sex attraction in adulthood. How will the trial avoid unnecessarily medicalising children who would otherwise grow up to be healthy, same-sex attracted adults?”

Challenges to the puberty blocker trial have been given prominent coverage across British media. At last count, more than 70 MPs and 35 peers had put their names to a cross-party letter organised by independent politician Rosie Duffield asking Streeting to abandon the trial. Her December 5 letter claims the trial is “a dangerous mistake that could devastate the physical, psychological, sexual and reproductive health of over 200 vulnerable children, leaving them medically dependent for life”.

The Sun newspaper reported that Labour Prime Minister Sir Keir Starmer was facing “a growing revolt” within his own party over the trial. All five UK MPs of Nigel Farage’s populist-right Reform party have signed a letter to Sir Keir calling for an immediate halt to the trial, which they said would “place children at foreseeable risk while offering no credible justification that any potential benefit outweighs the harm”.

In an editorial, The Times opposed the trial as “indefensible” and difficult to reconcile with Dr Cass’s own warning that puberty blockers were “powerful drugs with unproven benefits and significant risks”. The newspaper argued that the ethical alternative to the trial was a proper follow-up of the thousands of former Tavistock patients such as Bell.

A perilous pivot

South Africa | HIV clinicians and their institutions have unwisely pivoted in South Africa to promote the poorly evidenced medical treatments of “gender-affirming care”, according to an article in The Daily Friend newspaper by Dr Janet Giddy, a physician whose experience includes HIV, tuberculosis and rural medicine.

“With no oversight, HIV clinicians uncritically stepped into a role they were never trained for, and unfettered by the rigours of scientific method, boldly promulgate ‘Gender-Affirming Healthcare for South Africa’,” she wrote. Dr Giddy, a member of the group First Do No Harm SA, argued that this embrace of ideological gender medicalisation might create a pretext for politicians to defund evidence-based HIV programs, and result in people dying.

Gender racketeering

America | Florida’s Attorney-General James Uthmeier has filed a court action accusing the organisations behind gender-affirming care of deceptive trade practices and racketeering. The complaint alleges that the World Professional Association for Transgender Health (WPATH), the American Academy of Pediatrics and the Endocrine Society knew there was no credible evidence for the medical model they promoted and they had engaged in a “co-ordinated campaign” to develop guidelines creating “a facade of legitimacy”.

“Defendants’ reprehensible and immoral actions capitalize on the mental distress of children—as well as the natural affections and fears of their parents—to help their members sell lucrative surgeries and drugs that irreversibly mutilate and chemically alter children’s bodies without providing any credible medical benefit,” the complaint says.

Uthmeier said: “For years, these groups insisted the [treatment] recommendations were settled science, but behind closed doors, they knew the evidence was weak. They knew the outcomes [were] uncertain and the risks very real”. “Children were irrevocably harmed because truth was replaced with political activism. When organizations make medical claims, they have a duty to be honest. When they intentionally mislead families, their members and the medical profession, we hold them accountable.”

The complaint says the gender-affirming “house of cards” has collapsed as a result of the UK Cass review (which exposed the circular referencing of low-quality guidelines); leaked WPATH files with damaging admissions by gender clinicians; and evidence of scientific misconduct by the gender-affirming lobby revealed in US litigation discovery.

Dr Kurt Miceli, of the medical watchdog group Do No Harm, welcomed the lawsuit. “The years-long coordinated campaign by WPATH and other medical organizations to disregard the serious health risks of sex-change interventions on minors will go down as the most egregious medical scandal in modern history,” he told National Review.

“These groups have obfuscated risk and misrepresented the low quality of evidence to support puberty blockers, cross-sex hormones, and surgeries for children—interventions that can cause lasting harm. It is encouraging to see our elected officials hold these organizations accountable for spreading misinformation. This is a critical step to restoring public trust in medicine.”

In Texas, another Republican state that has outlawed gender medicalisation of minors, Attorney-General Ken Paxton said he had launched the first state action alleging healthcare fraud by gender doctors. The allegation is that two doctors concealed the fact of unlawful gender transition procedures for minors “by falsifying records, altering diagnosis codes, and submitting deceptive billing information”, thereby fraudulently obtaining Medicaid reimbursement.

Starved of sanity

Belgium | The death by suicide of “Aero”—a trans-identified 18-year-old girl who was allegedly approved for testosterone after a consultation lasting less than one hour—has led to a high-profile lawsuit against the AZ Groeninge Hospital in Belgium, Genspect has reported.

“The lawsuit concerns possible involuntary manslaughter or criminal negligence. The parents claim that the hospital displayed gross negligence by conducting insufficient psychological screening and failing to properly assess the family’s medical history. If Aero’s treatment is found to have been negligent, this could set a precedent and expose other Belgian institutions to legal liability. The repercussions for protocols, responsibility, and the wider field of transgender care could be considerable.”

Meanwhile, the Belgian media outlet La Libre has published an opinion article linking the tragedy of Aero to two other recent suicides of young females and the “massive social contagion” of trans identity. “The mental health of young Belgians is collapsing,” say the authors, writing on behalf of the women’s group Pour les Femmes/Voor Vrouwen. “And gender ideology, which sells transition to teenagers (and young adults in deep distress) as a magic solution to their unhappiness, bears overwhelming responsibility for these deaths.”

“These young people are not necessarily suffering because they are ‘trans’. They are suffering, truly, absolutely, desperately—severe depression, autism, self-harm, internalised homophobia, trauma—and they are being led to believe that ‘changing sex’ will solve everything. This is a criminal lie.

“Imagine, twenty years ago, that a doctor, responding to the profound suffering of a 15-year-old girl with anorexia, said to her: ‘You’re right, you were born in a body that’s too fat. We’re going to prescribe you appetite suppressants. We’re going to operate to insert a gastric tube for life and inject you with hormones to block your growth. You’ll finally be yourself’.

“There would have been an outcry. People would have talked about mutilation, medical crime, collective madness. Doctors would have lost their licences. Parents would have filed complaints. But today, that’s exactly what we’re doing with gender dysphoria. We call it ‘affirmation’. We call it ‘care’. And we allow teenage girls and young women to sterilise and mutilate themselves for life because a TikTok algorithm told them it was the solution.

“The anorexic wants to disappear as a sexual woman. So does the trans-identified girl. Same mechanism. Same hatred of the pubescent body. Same flight from impending femininity. Same refusal to grow up. The only difference? Anorexia has finally been recognised as a mental illness. ‘Rapid’ gender dysphoria is celebrated as a courageous identity. We are witnessing immediate validation by society.”

Maturation as disease

International | In a talk on the history of puberty blockers published in the UK Medico-Legal Journal, Oxford University sociologist Professor Michael Biggs suggested this novel use of medicine has the potential to unsettle our understanding of human development.

“I think the final broader cultural ramification of puberty suppression is that you begin to conceive puberty not as a crucial life stage that we all have to go through in order to become adults, but as literally a disease or almost like a disease. As [psychiatrist Professor Annelou] de Vries, the most published Dutch gender clinician, says, ‘Disallowing puberty suppression, resulting in irreversible development of secondary sex characteristics, may be considered unethical’.”

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Video: US author Abigail Shrier on the hubris of bad therapy and its perils for youth

Bad education

Australia | An educator at the Queensland Children’s Gender Service told health professionals in a public webinar that gender dysphoria was innate, according to documents released to GCN under Right to Information law. A clinical psychologist who attended the webinar wrote to Children’s Health Queensland chief executive Frank Tracey to complain of “multiple factual inaccuracies” in the 2022 webinar and the inability or refusal of the educator and then the gender clinic to answer questions “about their most basic definitions, statistics or practices”.

The psychologist had never heard before the claim that gender dysphoria was innate; the educator offered no evidence to support this statement. GCN put the issue to Toronto-based clinical psychologist Dr Ken Zucker, a world authority on gender dysphoria. “Any ‘educator’ who claims that gender dysphoria is completely ‘innate’ is, I am sad to say, not very educated,” Dr Zucker said.

Other correspondence released to GCN shows that the Queensland authorities responsible for the Brisbane-based gender clinic have been alerted by health professionals to the full range of evidentiary, clinical, ethical and medicolegal concerns about the gender-affirming treatment model for vulnerable minors. Over this period, the authorities instead sought to silence, discipline and dismiss the Queensland whistleblower psychiatrist Dr Jillian Spencer, who had told them the treatment model was unsafe.

A report from an independent review of puberty blockers and cross-sex hormone use in Queensland was delivered on November 30, as scheduled, to the director-general of the state health department, Dr David Rosengren, according to the office of Health Minister Tim Nicholls. At the time of this Substack post, there was no announcement on the result of any Cabinet consideration of the report from psychiatrist Professor Ruth Vine, and a review-linked pause in new public sector treatment with blockers and hormones remains in force. It is unclear if the Vine report will be made public.

Winging it

International | In videos obtained and recently reported by The Free Press, gender clinicians are shown eager to accommodate an increasing number of extreme surgeries—such as “nullification” procedures for self-declared eunuchs or the creation of a pseudo-vagina while preserving the penis—pushing well beyond any safety data. One clinician in a video of the 2022 WPATH conference at Montreal, Canada, said she and other gender-affirming colleagues felt “we’re all just winging it, you know? And which is okay, you’re winging it too. But maybe we can just, like, wing it together.”

Data-averse science

Italy | Eight medical and gender-sexology organisations in Italy have issued a letter opposing a government draft law that would impose stricter controls over prescription of puberty blockers and cross-sex hormones for minors, and require national collection and reporting of treatment data. The draft law, under which these hormonal drug uses would require sign off from a national paediatric ethics committee, is being examined by a parliamentary committee. The Meloni government’s regulatory intervention followed concern about treatment practices at Florence’s Careggi hospital and a sobering report from the National Bioethics Committee.

In its December 12 coverage of the letter in opposition to the law, the liberal newspaper Domani declared: “Puberty does not wait for parliamentary deliberations, experts remind us. It proceeds inexorably, and any delay in treatment can have irreversible psychological and physical consequences”. The letter, according to Domani, “asks that decisions be made based on data, not fear”. The newspaper headline read: “The scientific community raises alarm over the ‘gender dysphoria’ bill: ‘It denies treatment to minors and violates European guidelines’.”

But the parents’ group GenerAzioneD said the signatories were a “self-referential” minority within the scientific community, noting that they did not include any of the scientific societies for the fields of psychology, psychotherapy or psychiatry, whose work offers a cautious first-line response to gender distress. The letter cited new gender-affirming but low-quality guidelines from Germany, while ignoring more cautious treatment policy from Finland, Sweden and the UK, all of which relied on gold-standard systematic reviews and took into account the weak and uncertain evidence base for blockers and hormones.

“In the face of such widespread scientific disagreement at the international level, one would expect authoritative scientific societies to adopt an attitude marked by prudence, epistemological caution and reporting of clinical outcomes,” GenerAzioneD said. “On the contrary, the statement [of the eight organisations] relies mainly on a generic reference to the right to self-determination, an ethical-legal category which, although relevant, cannot replace clinical analysis, especially when it comes to minors and potentially irreversible treatments.”

“The most critical point in the [letter opposing the draft law], however, lies in a fundamental contradiction: the signatory societies claim the existence of ‘scientific evidence’, but do not produce Italian data on access, treatment or clinical outcomes. Yet they criticise a decree establishing a national register of medicines, which would be the minimum tool needed to start collecting such information.”

On November 26, GenerAzioneD’s president appeared before the parliamentary committee inquiring into the draft law, stating that, “In Italy, there is no up-to-date systematic data [on the gender medicalisation of minors]: for this reason, our association considers it essential to establish a national registry, also in view of the fact that drugs are administered off-label. For truly informed consent, parents must have access to clear data on the evolution of therapeutic pathways, including hormone treatments, psychological support, surgical interventions, dropouts and detransitions.”

Kiwi tantrum

New Zealand | An NZ government decision to ban new prescriptions of puberty blockers for gender distress—due to take effect on December 19—secured 50 per cent support in an independent poll commissioned by Family First NZ. Just under a quarter of respondents opposed the ban, and just over a quarter were uncertain. Much of the NZ mainstream media coverage of the ban, announced by centre-right National Party Health Minister Simeon Brown on November 19, was emotive and heavy on identity politics, but weak on the scientific debate and the international shift towards more cautious treatment policy.

On December 1, the gender-affirming lobby PATHA filed a court application seeking to restrain the ban. In a statement, PATHA president Jennifer Shields, said: “These regulations are being enacted based on politics, not on clinical evidence or best-practice decision making. We won’t let transgender children in Aotearoa [New Zealand] be subjected to harm just to ‘win a war on woke’.”

“This is an ideological tantrum escalated to legal action,” was the response of NZ political commentator Ani O’Brien. “The decision [on the ban] by Cabinet was based on clinical evidence, lack of regulatory approval, other credible jurisdictions making similar bans, and, of course, observable reality.”

Shields is a trans-identified individual, not medically qualified, and self-described as “a queer and trans artist, activist, advocate and educator”. PATHA is New Zealand’s iteration of the World Professional Association for Transgender Health, meaning it too is a hybrid health-activist entity.

Update, December 17: NZ High Court judge Michelle Wilkinson-Smith has granted PATHA an injunction stopping enforcement of the puberty blocker ban until its judicial review case can be heard. The judge said the government’s handling of the ban “had the effect of taking PATHA and the whole transgender community by surprise”, despite a preceding consultation round. The judge accepted evidence from one of PATHA’s witnesses, a doctor whose identity was suppressed, that puberty suppression is reversible and allows the child time to think and mature.

The judge also stated there was no evidence that blockers harmed fertility. The NZ Health Ministry itself, three years ago, abandoned the claim that blockers are “safe and fully reversible”. Today’s 38-page High Court ruling makes makes no mention of international data that most children begun on blockers proceed to cross-sex hormones, a combination likely to sterilise them.

The judge highlighted PATHA’s judicial review argument that the outright ban chosen by Cabinet was not Health Minister Brown’s preferred position, nor the option advised by his ministry. The case suggests that gender-affirming talking points, at odds with the evidence base, remain influential within the various branches of NZ government. The judicial review points are to be heard “with all possible urgency”.

Polisci

America | A review commissioned by the US Department of Health and Human Services (HHS) is an unlikely opportunity to transcend the Left-Right distortion of the debate over paediatric gender medicine, according to liberal journalist Lisa Selin Davis. Unlikely because the HHS report is the result of an executive order by President Trump and has therefore been dismissed out of hand by many liberals. An opportunity because the revised HHS report now carries the imprimatur of peer review and its previously anonymous authors have been revealed as being anything but MAGA-central.

Davis appealed to those on the Left to consider the report on its merits: “We Democrats have to push past the Left/Right framing, because we claim to be the party of science, and this is where the science leads—away from calling gender-affirming care for youth ‘evidence-based’ or ‘lifesaving,’ and perhaps away from providing these interventions at all”.

In an article for the media outlet STAT, the HHS report authors said they understood the Trump-tied scepticism. “But we are a politically diverse group,” they said. “Most of us are liberals and longtime Democratic Party supporters. All of us share a commitment to evidence-based medicine and have been willing to stick our necks out, often at personal or professional cost, to speak the truth. We did not expect HHS to entrust this sensitive task to us; it could have chosen a team that was ideologically aligned with the current administration. We are grateful that the administration set aside coalition politics and chose us instead.”

Meanwhile, the watchdog group Do No Harm has issued a critical analysis of a May 2025 report in the state of Utah which appeared to vindicate the gender medicalisation of minors. That Utah report “fails to meet the basic requirements for being considered a systematic review,” Do No Harm said, adding that it had cited a large volume of data favouring gender-affirming care without acknowledging the low quality of the data, and uncritically relied on activist guidelines undermined by actual systematic reviews of the evidence base.

Backyard hormones

United Kingdom | As post-Cass restrictions bite, more British teenagers appear to be sourcing powerful cross-sex hormones from dubious sources, The Times has reported. “Some get them from online suppliers in India and Russia, others are using drug dealers who offer testosterone and oestrogen alongside party drugs such as ketamine and MDMA, while others are ‘home-brewing’ the drugs using raw ingredients bought for pennies, and sharing them among those they meet online,” the newspaper said.

At London’s Great Ormond Street Hospital for Children, 12 per cent of the minors in the new gender clinic owned up to getting hormones outside the National Health Service. Testosterone and oestrogen for youth gender dysphoria have not been banned within the NHS, but prescriptions have been tightened up.

Clinical psychologist Anna Hutchinson, a Tavistock clinic whistleblower now working privately in London, said 40 per cent of the minors in her practice were self-medicating. “I’m seeing a surge of the older adolescents—the 15, 16, 17-year-olds—just skipping all medical supervision entirely, which I’m really worried about,” she told The Times. “A lot of them are on testosterone and oestrogen, and usually not with parental approval or any medical oversight.” Meanwhile, consultation of a new NHS clinical pathway for patients who wish to detransition is to close on December 28.

Fully misinformed

America | US Medical societies and journals are guilty of misinformation, erroneous and unsupported claims, and censorship of justified corrections—all in order to maintain the appearance of consensus in favour of gender-affirming care for minors, according to an analysis in the Journal of Controversial Ideas by J Cohn of the Society for Evidence-based Gender Medicine.

Claims protected from challenge include overstatement of the likely benefits of these medical treatments, minimisation of the risks, and omission of less risky treatment alternatives. This not only corrupts the scientific literature but is also “medically dangerous,” Cohn argues. “In medicine, ethical informed consent means a person understands the benefits, risks, and alternatives (including ‘doing nothing’) before consenting to undergo treatment.”