Portugal on track to ban blockers

A draft law to stop the gender medicalisation of minors is up against organised resistance and captured media

Photo by Shobhit Sharma on Unsplash

What children are owed

Children have a right to “full development” and the protection of their future life choices, according to a Portuguese draft law that would ban puberty blockers and cross-sex hormones for gender-distressed minors.

The bill put up by the centre-right Christian democratic CDS-PP party secured enough support to pass its first reading in parliament on March 20, being approved in general and referred to the Committee on Constitutional Affairs, Rights, Freedoms and Guarantees for detailed debate and possible changes before a final vote.

CDS-PP is a member of the centre-right minority coalition government, the Democratic Alliance.

Portugal’s centre-left president, António Seguro, has the power to veto bills or promulgate them as law.¹ Gender-affirming clinicians have launched a campaign against the proposed restriction of hormonal treatment for minors, claiming puberty blockers are “reversible” and resorting to the “transition or suicide” narrative.

Children as young as 11 are being referred for blockers at their first appointment in Portugal, and even primed on future surgery options during the same consultation, according to Youth in Transition, a Portuguese group of parents and young people opposed to gender medicalisation. Young adults are reportedly given cross-sex hormones with little caution or delay.

The CDS-PP draft law prohibiting paediatric hormonal treatment was one of three anti-gender ideology bills given first-reading approval by parliament last Friday with strong support across the political right.

Each bill seeks the repeal of Portugal’s 2018 trans-activist policy, which enabled legal sex change for adults without any medical oversight, and gave the same self-ID right to teenagers aged between 16 and 18 with parental approval and a health professional’s report.

The 2018 measure was “one of the most damaging gender self-identification laws in the European Union” and ended screening for co-morbidities such as autism, mental health issues, trauma and internalised homophobia, said Marisa Antunes, a Portuguese journalist who follows the gender issue.

“This law was passed in 2018 with virtually no public debate, with all left-wing parties voting in favour,” she said.

Its repeal, approved in principle by parliament on March 20, would reinstate a 2011 law requiring a medical certificate before an official change of name and sex.

Antunes said that key institutions in health—including the Portuguese Society of Clinical Sexology, the Order of Psychologists, and the College of Sexology of the Medical Order—were “ideologically captured”.

“They have joined forces to maintain the current [2018 trans] law and have presented to the parliament ‘scientific’ documents contesting the reliability of the Cass report, endorsing the World Professional Association for Transgender Health guidelines, and fiercely defending hormone blockers ... with no questioning at all by the media,” Antunes told GCN.

Since last Friday’s vote, she said, mainstream media coverage has kept recycling the story of “transgender people who struggle to be accepted” but made no reference to the plight of young people caught up in rapid-onset gender dysphoria.

However, on the eve of the historic vote, a prominent psychiatrist and suicide prevention researcher, Dr Ricardo Gusmão from the University of Porto, joined the debate to challenge the claims of the gender-affirming side.

On his LinkedIn page he published a summary of his devastating analysis of three scientific documents sent to the parliament by the Society of Clinical Sexology (SPSC), the Order of Psychologists (OPP), and a group of 210 health professionals—documents opposing reform of the 2018 trans policy and advocating for gender medicalisation.

Using the international GRADE system to rate the quality of research data, Dr Gusmão found that 80-92 per cent of the references cited in these three documents involved low-quality evidence or very low-quality evidence.

In his analysis, which he sent to parliament, he warned that the three documents in question ignored or underplayed—

the exponential international growth in demand for youth gender medicine and the possible role of social contagion;

the potential for puberty blockers to “interfere with brain and cognitive maturation during critical developmental windows”;

the doubtful capacity of minors to make irreversible medical decisions;

recent studies indicating a 10-30 per cent long-term detransition rate;

and “the medicalisation of homosexuality—concern that affirmative care may function as reverse conversion therapy for young people who would otherwise grow up to be LGB adults.”

“The opinions of the SPSC, the group of professionals and the OPP present themselves as technical-scientific but rely predominantly on evidence of very low or low quality,” Dr Gusmão said.

“By ignoring the most robust systematic [evidence] reviews of the last decade and the clinical paradigm shifts that have occurred in several European countries, they fail in their mission to guide political decision-makers on the basis of the highest standards of evidence.”

Dr Gusmão recommended that Portugal follow the more cautious trajectory of countries such as the UK, Finland and Sweden; classify hormonal treatments of minors as experimental and restrict them to research; and adopt psychotherapy and psychosocial support as the first-line treatment for youth gender distress.

The CDS-PP bill also notes the striking rise of restrictive policies on the treatment of minors with puberty blockers and cross-sex hormones in several countries as “the scientific evidence has increasingly been called into question”.

Finland’s Professor Riittakerttu Kaltiala, a leader in the international shift away from “gender-affirming care”, will present an April 14 webinar explaining her change of approach. The webinar, “Medical gender reassignment in minors: Why are we cautious in Finland?”, is to be hosted by Australia’s National Association of Practising Psychiatrists.

Professor Kaltiala’s talk had been scheduled for March 10 by the Royal Australian College of General Practitioners but did not go ahead after the college buckled to activist pressure.

Ideology, not science

Paulo Núncio, who leads the CDS-PP in Portugal’s parliament, said “there is no scientific basis for administering puberty blockers [for gender dysphoria],” Euronews reported.

He said “ideology has replaced truth and science, and 12-year-old children have been turned into guinea pigs for ideological obsessions”. “It was the greatest delusion of wokeism against children in Portugal. These therapies must end, and now.”

The bill invokes the right of parents “in carrying out their irreplaceable role in relation to their children”, the right of a child to “full development”, and the need for “protection against situations that may compromise such development”.

It also cites the principle that “decisions taken during childhood must not disproportionately limit the individual’s future life choices before they reach sufficient maturity to fully exercise their autonomy”.

“Among the frequently cited concerns [about the use of puberty blockers to interrupt normal growth] are impacts on bone mineral density, neurocognitive development, psychosocial maturation, the exacerbation of psychiatric conditions—notably suicidal tendencies—and future fertility,” the bill says.

It references the European Academy of Paediatrics’ 2024 statement on youth gender dysphoria which acknowledges a qualified “compassionate grounds” argument for puberty blockers while conceding serious concerns about this “off-license” drug use.

“Although widely licensed to treat precocious puberty, [this drug] use in [gender dysphoria] is controversial, not least whether [this] use is experimental or innovative. Some countries now restrict [blockers] to research, or to an exceptional/case-by-case basis,” the academy’s statement says.

“[Puberty blockers] may irrevocably lead to the use of trans-sex hormones and surgical transition, so it may arguably compromise rather than facilitate freedom of choice.”

The Portuguese draft bill says: “In the case of interventions intended to interrupt or alter the natural course of puberty, decisions made during childhood have profound repercussions on physical, reproductive and psychological health throughout adulthood.

“The issue of minors’ legal capacity to consent to complex medical procedures with long-lasting consequences is therefore of particular importance, especially where such profound changes are involved as those considered in cases of gender incongruence or gender dysphoria.

“The greater the complexity, irreversibility or existential impact of a medical intervention, the greater the requirement for maturity and capacity to give valid and fully informed consent.”

The bill seeks to “protect the integrity of children” and would regulate both public and private healthcare.

It stipulates that—

“The prescription, dispensing or administration to minors under the age of 18 of medicines, hormone therapies, pharmacological treatments, or treatments of any other nature, intended for the hormonal blocking of puberty or the induction of characteristics corresponding to a sex different from the minor’s biological sex, in the context of gender incongruence or dysphoria, is prohibited.”

If enacted, the bill would make an exception allowing hormonal treatment of “minors with proven sexual ambiguity or endocrinological or genetic disorders, who are duly monitored by a medical and multidisciplinary team”.

Of the other two draft laws referred to the committee on March 20, the bill from the social democratic PSD party would tighten up the rules for legal sex change, while the bill from the populist-right Chega party would banish gender ideology from the school curriculum as well as prohibiting paediatric medical transition.

The trans-activist lobby Opus Diversidades deplored the bills as “a setback in terms of human rights in Portugal”. The well-funded LGBTI+ lobby, ILGA Portugal, has been prominent in the campaign to entrench gender ideology in state policy and to defend it from parliamentary reform.

1. Seguro owes his election as president this year not only to support from the political left but also from centre-right voters who preferred him to his populist-right rival, André Ventura of the Chega party.

A president’s veto of a bill can be overturned by an absolute majority in parliament. The parliament may take into account the president’s objections to a draft law and modify it. As well, the president may refer a draft law for review by the Constitutional Court.