GCN global briefs
Catastrophe
Sweden | Despite new cautious guidelines issued in 2022 by Sweden’s National Board of Health and Welfare, child and adolescent psychiatrist Dr Sven Román warns that “the current situation for young transgender people remains catastrophic” and represents “the biggest medical scandal Sweden has ever seen”.
“Affirmative treatment continues to be practised, despite the healthcare system having officially declared a precautionary principle,” Dr Román says. “The doctors at the specialist clinics for gender dysphoria—who, in my view, have committed thousands of irreversible acts of abuse against children and young adults with gender dysphoria—remain in their posts. They have understood nothing. Their clinics are akin to fanatical religious sects. And the authorities’ monitoring of compliance with the National Board of Health and Welfare’s new recommendations, dated December 2022, is a complete farce.”
Charts provided to GCN by Dr Román show an increase in the number of under-18 males diagnosed with gender identity disorder (F64 code in the ICD system) since 2020 and a decrease in this diagnosis for under-18 females since 2018. In the age group 20-24, the trend for both males and females has been an increase in numbers with the F64 diagnostic code especially since 2012. (Under-25s have brains that are not fully mature and may make treatment decisions without due foresight.)
More than shocking
The Netherlands | Professor Armand Girbes—former head of the intensive care unit at the university hospital where the Dutch protocol was developed—has appealed for healthcare based on evidence, not ideology. He directed his appeal to the University Medical Centre Groningen (UMCG) and the Amsterdam University Medical Centre (UMC), both with gender clinics and the latter home to the famous Center of Expertise on Gender Dysphoria.
“A University Medical Centre (UMC) should stand for academic care—care based on scientific insights, free from ideology. This also involves having the courage and willingness to engage in substantive debate about medical treatments. Well, that is no longer the case at, of all places, my alma mater, the UMCG, and Amsterdam UMC. There, ideology-driven treatments are being administered to vulnerable adolescents and children instead of the best possible care.
“The scientific literature is crystal clear, and the UMCs are seriously violating the fundamental principle of ‘Primum non nocere’. But the ideological lobby is strong—so strong that the [Dutch] Health Council committee, 50 per cent of whose members had a serious conflict of interest, produced a report that cannot be described as scientific. Critics and the children’s parents are systematically excluded. Because critical doctors, even with the science on their side, do not dare to speak out openly, I was asked months ago to look into the matter and speak out.
“As an intensive care specialist, you regularly see the complications and the patients, but I had not studied the literature and relied on what I heard from the treating doctors. But now I know, and things are seriously wrong. The [public broadcaster] NPO invited me to take part in a live TV debate on a programme known for its integrity. But neither the Health Council nor the university medical centres dared to take part in the debate. And now the university medical centres are shrewdly obstructing and cancelling the debate in the [Dutch] House of Representatives. Critics and parents are being told to keep quiet by the UMCs. It is more than shocking.”
Gendered politics
United States | Ahead of the US midterm elections, The New York Times published a news report headed, “Trans Issues Helped Elect Republicans in 2024. Will It Work Again?” with the kicker: “In an election that has often focused on the economy, Republican groups are featuring transgender issues in ads, portraying Democrats as extreme and out of touch.” GOP strategists referred to in the article cite polls showing most Americans “favor banning gender-related medical treatments like puberty blockers and cross-sex hormone therapy for adolescents”.
At one point, The Times news report implies that the political right is giving disproportionate attention to an unimportant niche issue. The article also says: “Some Democrats warn that the party risks alienating its own base by distancing itself from transgender issues, which it has for over a decade held up as a critical civil rights battle.” Reporter Amy Harmon’s beat is described as covering “how shifting conceptions of gender affect everyday life in the US”.
Worse than the Tavistock
United Kingdom | Former paediatrician Dr Hilary Cass, whose review was triggered by hasty medicalisation at the London-based Tavistock gender clinic, has called for an independent inquiry into the failure to prevent harm at a primary care clinic in Brighton, England. She says the scandal at Brighton “dwarfs” that at the Tavistock, journalist Hannah Barnes reports for The Sunday Times in late October.
In 2024-25 the Brighton practice WellBN, where a trans-identified doctor Sam Hall worked, wrote almost 1,100 hormone prescriptions for patients under 25. “That amounted to 15 per cent of all testosterone prescriptions issued for under-18s across the whole of London and the southeast. For 18-20-year-olds, the figure was a quarter,” Ms Barnes writes.
At the centre of the story she reports is the silencing and victimisation of Dr Sarah Redvers, who raised concerns about Dr Hall as far back as 2020. In June 2026, a safety investigation into Dr Hall and his colleagues found that puberty blockers and cross-sex hormones had been prescribed to young children contrary to National Health Service guidelines.
“The report examined the records of 78 children who had received the drugs between January 2023 and December 2025 after ‘wholly inadequate’ assessments,” Ms Barnes writes. As for Dr Redvers, she says she does not feel vindicated. “It absolutely could have been prevented—all of it,” she says.
Ms Barnes asks: “Why did so many people fail to act on her concerns? Some in NHS Sussex believed Hall’s work was beneficial, Redvers said. But alongside that was fear: people were frightened about being called transphobic.”
Healthcare, at last
United States | The first dedicated clinic for detransitioners in the US opened on October 26 at Texas Children’s Hospital, which previously had run a large clinic offering medical transition to minors. The dramatic change in approach follows a settlement between authorities and the hospital, which was accused of using false diagnosis codes to conceal unlawful gender medicine. The new detransition clinic has services including endocrinology, fertility counselling and psychological support. Detransitioner care is also available at the Cleveland Clinic in Ohio.
Meanwhile, a new analysis of data in Washington state shows at least 15,437 minors—one in 58 teen girls in 2022—had a trans-related diagnosis on insurance claims from 2017 to 2023, according to Leor Sapir of the Manhattan Institute. The rate of teenagers with gender-linked diagnoses in 2022 was about 19 times the prevalence of paediatric Type 2 diabetes.
Criminalising conversations: Social scientist Matilda Gosling talks to Helen Joyce of the group Sex Matters about the dangers of a draft UK law likely to entrench the affirmative model
Who is converting what?
Australia | A bill that criminalises attempts to “convert” someone’s sexual orientation or gender identity has passed the Lower House of Parliament in the state of Tasmania; the maximum prison term is 21 years, and consent of an individual is not a defence.
The draft law was supported by the Premier of the minority government, Jeremy Rockliff from the centre-right Liberal Party. The centre-left Labor Party voted as a bloc in favour of the proposal, which emanated from the Greens. The next stage is consideration by the Upper House.
For the October 29 vote, the Liberals were allowed to follow their consciences. Mr Rockliff’s own Attorney-General, Guy Barnett, spoke against the bill. He said the proposed law left it “very unclear what actions are to be considered unlawful and potentially subject to criminal, civil or other enforcement action … Put yourself in the shoes for example of a teacher who has been approached by a student with questions about sex or gender identity.”
After the vote, Mr Barnett emphasised that the bill had passed in the Lower House “despite the many concerns expressed and flaws exposed. Likewise the call for an inquiry was denied.”
Eric Abetz, a former federal senator now a Liberal Party minister in Tasmania, also raised his voice in opposition. In a video posted to his Facebook page, Mr Abetz says he was against the bill “because it impinges on freedom of family discussions, free speech, freedom of association”.
He cites the reversals encountered by the affirmative medical model internationally. “Young people now are suing their governments and institutions for the puberty blockers that were administered to them, and for the promotion of the affirmation agenda, rather than having in-depth counselling and consideration of the issues that they are confronting.”
Critics of anti-conversion policies that include the subjective concept of “gender identity” have warned that the practical effect will be to discourage ethical psychotherapy as a response to gender distress in young people, leaving risky medicalisation as the only option.
On WIN TV, Isla MacGregor of the group Women Speak Tasmania argued that “affirmative care practices are in fact converting LGB people to trans”. The group had launched a petition for any such “anti-conversion” bills to be scrutinised by a public inquiry. “Young people distressed about their sex or body deserve compassionate, evidence-based care, including watchful waiting and exploratory counselling, without clinicians fearing legal sanction or pressure towards potentially lifelong medical interventions,” the petition says.
Paper chase
United States | Rhode Island Hospital has provided to a federal court more than 112,647 pages of de-identified records on its practice of paediatric medical transition, according to the Brown Daily Herald. The hospital had resisted the handover for several months. The US Department of Justice is investigating whether puberty blockers and cross-sex hormones have been prescribed “off label” to minors contrary to the Federal Food, Drug, and Cosmetic Act, which prohibits “misbranding” of drugs such as labelling that is false or misleading.
Woke wakes up
Canada | The Conservative Party of British Columbia has secured a majority government in an early election called by the leftist incumbents of the New Democratic Party. It is the first such Conservative victory in the progressive-leaning province since 1928, according to Reuters. The party in BC has been critical of “sexual orientation-gender identity (SOGI) programs. Lorne Doerkson, leader of the BC Conservatives, has said SOGI should be removed from schools. He questioned its promotion as simply an anti-bullying project, and described it as a “lightning rod for division” and a cause of confusion. The party is pledged to “Increase parental transparency and choice, including access to curriculum materials, appropriate notification and opt-out rights, and repeal of [the BC program] SOGI 123”.
Childcare
Spain | The Spanish parents’ group AMANDA is hosting a multidisciplinary conference in Madrid on November 13. Under the rubric of “Beyond the labels”, presenters at the one-day meeting include Málaga endocrinologist Dr Isabel Esteva, detransitioner Ana Rosales, and health law specialist Dr Carlos Sardinero as well as international figures such as Genspect founder Dr Stella O’Malley and Tavistock clinic whistleblower Sue Evans.
“This landmark event aims to raise awareness and strongly denounce the medicalisation, cross-sex hormone treatments, and irreversible surgeries being performed on our children,” AMANDA says. (AMANDA is a Spanish acronym for the Association of Mothers of Adolescents and Children with Rapid-onset Dysphoria. Eight mothers came together in 2021 to form the group; today, fathers are also involved.)
Final, final rule
United States | The US Department of Health and Human Services (HHS) has published a clarified final rule intended to prevent the use of federal disability law to mandate provision of gender medicine to minors. The Biden Administration had sought to include gender dysphoria as a disability under Section 504 of the 1973 Rehabilitation Act. Under that section, all programs and activities with HHS funding must not discriminate on the grounds of disability. The clarified final rule of October 30 argues that the Act was never intended to apply to a condition, such as gender dysphoria, which is “not resulting from physical impairments”. There had been ambiguity on this point in the preamble of a previous final rule.
HHS also summarised public comments on the latest, proposed final rule. “A group of commenters expressed support for the proposed rule based on the belief that if gender dysphoria could be a disability under section 504, clinicians would be required to provide sex-rejecting procedures and counseling to patients to treat such gender dysphoria under the theory that preventing, limiting, or interfering with such procedures may amount to disability discrimination. Some commenters also stated that if gender dysphoria is considered a disability under section 504, then the Department considers such gender dysphoria to amount to an immutable characteristic.”
Not doing nothing
The Netherlands | The report of the Dutch Health Council—which acknowledged the weak evidence for paediatric gender medicine but saw no reason to curtail the practice—has been critically analysed by philosopher Dr Jilles Smids of Erasmus MC and Professor Patrik Vankrunkelsven of the Belgian Centre for Evidence-Based Medicine. Among the issues tackled by their 94-page paper is the council’s recycling of the gender clinicians’ mantra that “doing nothing”, rather than affirmative medicalisation, is not a neutral position and may do harm.
Their paper says: “The harms of not treating are the mirror image of the benefits of treating; if a treatment yields health benefits, then the harm of not treating is the forgoing of those health benefits. So, if there is no plausible evidence of health benefits, there is also no basis for saying that not treating is harmful.”
The authors also reject the claim that not giving a child puberty blockers or cross-sex hormones necessarily means “doing nothing”. They write: “Whilst waiting to see how the child’s identity develops further, non-medical interventions can, after all, be applied, such as psychosocial support and treatment of co-occurring psychiatric problems.”
“And indeed, puberty continues in the meantime and the body undergoes irreversible changes. However, based on current scientific knowledge, this may just as easily result in the [gender dysphoria] disappearing or being sufficiently reduced. In that case, the young person’s developmental prospects are also safeguarded … as they do not need to embark on a radical medical course of treatment with all its risks and loss of function.”
Upping the risks
United States | The drugs used as puberty blockers now come with a warning that they may increase suicide risk, the campaigner known as “Billboard Chris” Elston reports. In March this year, the US Food and Drug Administration used its power to mandate changes to drug labelling in the light of new safety concerns. Mr Elston cited a May 2026 FDA letter sent to the drug company AbbVie which noted concern that GnRHa drugs—used “off-label” to block the normally timed puberty of gender-distressed minors—carry “serious risks of suicidal ideation and suicidal attempt”.
AbbVie makes Lupron; as Leuprorelin it is used by paediatric gender clinics. The new warning on the label reads as “Psychiatric disorders—Suicidal ideation and attempt.” GnRHa drugs are approved for hormone-driven cancers, such as prostate cancer, as well as for fibroids, endometriosis and precocious (premature) puberty, but not for gender dysphoria.
An FDA spokesperson confirmed to GCN that “GnRH agonists and sex hormones do not have FDA approval for children’s gender care”.
“The FDA continues to monitor the safety of all approved products, including monitoring for suicidal behavior and ideation associated with use of gonadotropin-releasing hormone (GnRH) agonists and will inform the public and take regulatory action to protect the public health if appropriate. At this time, the FDA maintains that the benefits of these medications outweigh their risks when they are used according to the FDA approved labeling,” the spokesperson said.
Lost in the process
New Zealand | A court in New Zealand has ruled that the government’s regulations banning new prescriptions of puberty blockers are unlawful because of a failure to consult on the measures and their discriminatory effect on trans-identified minors. The ban announced in November 2025 by Health Minister Simeon Brown, from the centre-right National Party, followed an evidence review reporting “a lack of good-quality evidence to back the effectiveness and safety” of this off-label use of puberty suppression drugs with gender-distressed minors.
The blocker ban has been challenged successfully by the gender medicine lobby the Professional Association for Transgender Health Aotearoa (PATHA). Amid the uncertainty of an election campaign, the leader of the populist-right NZ First party, Winston Peters, has called on Mr Brown to lodge an immediate appeal. “Our country needs to come to our senses and base these critical health decisions on evidence, not on process,” he says. NZ First is a junior party in the Nationals’ coalition government. Minister Brown’s spokesperson would not comment on whether he supports Peters’ position.
In his October 21 ruling, High Court Justice Dale La Hood said it was not his role to weigh a mass of competing expert evidence. He went on to dismiss the government’s claim that the risk of harm outweighs the benefits of trans puberty blockade, in contrast to the use of hormone suppression with approved uses such as endometriosis and other conditions. In this context, the judge said “there is overwhelming clinical support in New Zealand for the use of puberty blockers to treat gender dysphoria/incongruence in this cohort; clinical use that has occurred for approximately 15 years (since 2011).”
“While the long-term benefits are uncertain, there can be no doubt that it has the short-term benefit of preventing the distress caused to gender dysphoric/incongruent youth experiencing permanent changes to their body that do not align with their gender identity.”
At odds with the findings of the Cass Review, the inquiry by the UK suicide prevention expert Professor Louis Appleby and Finnish register studies, the judge gave credence to the “trans suicide” narrative. He said there was “extensive evidence from highly qualified clinicians about an increased risk of serious and life-threatening health outcomes from blanket denial of access”.
In remarks not necessary to decide the case, Justice La Hood suggested the government’s ban may breach a Bill of Rights provision upholding “the right to life”. His reasoning is that the government’s action would lead to a “clear and foreseeable increased risk of suicide to an identifiable and vulnerable cohort”.
Comment | In his ruling, Justice La Hood uncritically repeats a trans lobby smear when he refers to Dr Alison Clayton, an Australian expert witness in the case before him. The judge wrote: “PATHA notes that she is affiliated with the Society for Evidence-Based Gender Medicine, a United States organisation that has been named as an anti-LGBTQI+ hate group by the Southern Poverty Law Centre.” Despite the lack of evidence, this smear persists. Dignifying it reflects poorly on a judge. (Disclosure: SEGM has been a news source for me since 2019.)
I can’t even
International | In a recent paper on the turn to “No debate” in higher education, philosopher Dr Holly Lawford-Smith discusses an example from gender ideology. She notes that a 2019 article about trans studies in Transgender Studies Quarterly acknowledges the “no debate” position on paediatric medical transition. That article says: “We are in the era of the trans child. It would be absolutely unfounded to imagine a trans studies scholar saying that perhaps, actually, trans children should not be given hormones. As a field we do not allow for those kinds of disagreements. Everything must be ‘gender affirming’ (whatever that means).”
Who decides?
Australia | A new feature documentary, which will premiere in Melbourne on November 5, deals with the intersection of trans activism, female-only sport, the Tickle vs Giggle case, free speech and politics disguised as healthcare. (Disclosure: I was interviewed for the film.)
Grateful appreciation for your continued independent investigative reporting Bernard. We entrust that truth and reality will eventually prevail, yet in the meantime deception and false belief systems continue to take people in power captive at the expense of our most vulnerable.
Thank you so much for continuing to keep up to date with what’s going on. It really is like Whack-A-Mole as Stella says. I look forward to the doco 🙏