Puberty panic merchants
How can health professionals ignore the risks of rights-driven medicine and the trans suicide narrative?
Biology denied
My postgraduate clinical psychology training in the early 1970s included a strand on human sexuality and its problems, based on the groundbreaking work of William Masters and Virginia Johnson. This led me to specialise in the broad topic of human sexuality, not just sexual problems, although I always maintained a caseload in the general area of mental health; understanding the whole person is critical to good mental health care.
What fuelled my focus on this area was the extraordinary ignorance about sex at that time.
There were girls who hadn’t been told about menstruation and thought they were dying when they first saw blood, boys who didn’t know what had happened when they woke up and found a sticky substance on their sheets. I saw women who didn’t know until their wedding night that the penis became hard and erect.
Fifty years on, there are health professionals who apparently don’t know how babies are made or the difference between a female and a male.
School children are being taught in sex education classes that it is possible the doctor made a mistake, and they may not be the sex they thought they were. They are told there are more than two sexes. Now, instead of sex being observed at birth, the newspeak is that the doctor assigns the baby’s sex; terminology that suggests a possible error. Taking a huge, irrational step from the existence of people born with disorders in sex development—once known as intersex conditions—many of these health professionals tell young people not only can they choose to live in the gender role of the other sex, they can become the other sex if they take drugs to stop the impending unwanted puberty.
Access to “gender-affirming care” with puberty blockers and cross-sex hormones is now available in most western countries, and health professionals who express concern about the safety of this are typically labelled transphobic and often sanctioned in some way.
Protests against modern gender ideology and its impact on those young people who decide they are one of the many identities now crowded under the transgender umbrella have been described by trans activists as a “moral panic”—
“[O]rganised transphobia is promoted using similar strategies and politics as the wider reactionary movement which has become increasingly mainstream. In particular, we outline the transphobic process of ‘othering’ based on moral panics, which seeks to construct, homogenise and exaggerate a threat and to naturalise it in the bodies and existence of the ‘other’ (Emphasis added.)”
Puberty panic
The most contentious issue raised by gender ideology is the use of puberty blockers, which are claimed to stop the young person going through the puberty they don’t want in order to achieve the one they aspire to. These drugs are characterised as “lifesaving”—
“The importance of preventing development of secondary sex characteristics during this period cannot be overstated. Once these children, who are already experiencing considerable distress over their gender incongruence, undergo the pubertal development of the ‘wrong’ sex, their psychological well-being deteriorates significantly, and many develop depression and suicidal ideation.
“They can experience alienation and harassment at school if they are unable to participate in cross-gender activities or use cross-sex restrooms. They can be bullied and abused. Such circumstances can lead these youths to drop out of school and develop significant psychiatric morbidity. Because these risks can be so great, the need for medical and psychological intervention is paramount. Suppressing puberty and allowing children the opportunity to explore their true gender identities decreases their risk for suicide.
This hyperbole based on tenuous premises is clearly trying to establish a sense of panic about puberty for any gender-questioning child. Following the end of routine use of puberty blockers in the UK last year, a group known as the Good Law Project put on a disturbing display of this puberty panic and weaponisation of the threat of suicide—
“Since the NHS imposed restrictions on treatment for young trans people, deaths have surged. Whistleblowers and Tavistock [gender] clinic papers show this was not only predictable, but predicted at the time.”
This was shown to be demonstrably false in a review by the UK government’s suicide prevention adviser, Professor Louis Appleby, who said—
“The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock. The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide (Emphasis added.)”
Any competent health professional should be aware of the dangers of the puberty panic strategy, and understand that an emphasis on suicide “could prompt children under the age of 18 to take their own life,” as The Guardian paraphrased Professor Appleby.
Ahistorical
Trans activists have acknowledged that truth was never meant to be the basis of gender-affirming care—
“In summary, trans activists were advised to insist on ‘inclusive’ language (for example, ‘children’ instead of ‘boys and girls’), to attack on a personal level any woman or man who raised concerns about the assessment and management of gender-questioning people (‘bigot’, ‘transphobe’), to rubbish any research regardless of its scientific merits (‘anti-trans’, ‘biased’), and to present trans people as ‘vulnerable’, ‘marginalised’ and likely to suicide if not affirmed—all this as an emotional appeal to target any objectors as heartless bigots.”
Manufactured puberty panic is a damning example of making up data to suit the cause of trans ideology as there is no historical evidence to support it: long-term records of suicide rates for young people under the age of 14 show that suicide for any reason has always been thankfully uncommon, as gender-affirming health professionals should be aware.
Children were not added to the standards of care for gender-questioning people until 2001 and, to demonstrate the dangers of telling a group they are vulnerable and at risk of suicide, consider this statement from the American Academy of Pediatrics—
“Youth suicide is a serious public health problem, responsible for more deaths among youths ages 10 to 24 years than any single major medical illness. While rare in children younger than 10 years, suicide death rates increase markedly during adolescence and young adulthood. Pediatric suicide rates have increased significantly in the US, nearly tripling between 2007 and 2017 among children ages 10 to 14 years (Emphasis added.)”1
Bigger picture
Unfortunately, from the early 2000s there was a confluence of four societal shifts which impacted heavily on the mental health of children and adolescents.
1 Social media
It is an understatement to say that the development of the internet and the evolution of social networking have changed how we interact, communicate, and share in the digital age. Young people have grown up with this technology and may spend an excessive amount of time on these platforms, often driven by a desire for social validation, a need to check for likes and comments, and a compulsion to compare themselves to others online, which can lead to negative mental health impacts like anxiety and low self-esteem.
Of particular concern is the relationship between screen time and suicidal behaviours, defined as self-destructive acts intended to result in death. A 2023 US study of children aged 9-11 concluded that, “Higher screen time is associated with higher odds of reporting suicidal behaviors at two-year-follow-up.”
2 Gender ideology
Although advocates for Queer theory and its offspring, trans ideology, had been active since the 1990s, social media allowed them to speak directly to young people without any filtering by wary adults, despite the best efforts of parents to control screen time—
“While TGD [transgender and gender-diverse] adolescents used the internet and social media for similar purposes as peers from the general population, they also used the internet and social media to gain TGD-specific information and for gender identity expression and exploration. They reported both positive and negative experiences online, [exemplifying the need] for future studies investigating how online experiences affect TGD adolescents’ mental health and gender identity development.”
A 2020 study found “evidence of an association between increasing media coverage of TGD-related topics and increasing numbers of young people presenting to gender clinics. It is possible that media coverage acts as a precipitant for young people to seek treatment at specialist gender services, which is consistent with clinical experiences in which TGD young people commonly identify the media as a helpful source of information and a trigger to seek assistance.”
It is noteworthy that the authors of these studies, all identified as working in gender fields, chose to assume that young people were merely having a trans identity confirmed rather than being influenced to assume one due to the positive characterisation of being trans. This ignores mounting evidence of the association between use of social media and increased presentation to mental health services for a variety of mental health conditions. Some examples of this research—
Claims of dissociative identity disorder on the Internet: A new epidemic of Munchausen syndrome?
Teen ‘social media-induced illness’ requires careful workups
3 Mental health
Over the last decade an increase in youth mental health problems has been reported across the world. This is a complex issue and while social media may play a part, it cannot entirely account for this disturbing trend; the challenge is to understand what other factors may be at play.2
The World Health Organisation reported in 2024 that—
“Globally, one in seven 10-19-year-olds experiences a mental disorder, accounting for 15 per cent of the global burden of disease in this age group. Depression, anxiety and behavioural disorders are among the leading causes of illness and disability among adolescents. Suicide is the third leading cause of death among those aged 15–29 years old. The consequences of failing to address adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults.”
Reports from various countries show that the Covid pandemic had an impact, but it cannot account for the depth and breadth of the rising mental distress of young people. This 2023 report from the US summarises a situation that is similar across Western countries—
“The Covid-19 pandemic era ushered in a new set of challenges for youth in the US, leading to a mental health crisis as declared by the US surgeon general just over a year ago. But US children and teens have been suffering for far longer (Emphasis added.) In the 10 years leading up to the pandemic, feelings of persistent sadness and hopelessness—as well as suicidal thoughts and behaviors—increased by about 40 per cent among young people, according to the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System.”
4 Trans ID
The sudden and dramatic increase in young people identifying as trans has been well documented. The increase began slowly around 2012 followed by a sudden surge in 2015, with females far outweighing male presentations. That growth continues, as a 2022 news article recounts—
“The number of young people who identify as transgender has nearly doubled in recent years, according to a new report that captures a stark generational shift and emerging societal embrace of a diversity of gender identities. The analysis, relying on government health surveys conducted from 2017 to 2020, estimated that 1.4 per cent of 13- to 17-year-olds and 1.3 per cent of 18- to 24-year-olds were transgender, compared with about 0.5 percent of all adults. Those figures illustrated a significant rise since the researchers’ previous report in 2017.”
Of concern is the high rate of co-morbid mental health problems for trans-identifying young people and adolescents—
“Children with gender dysphoria often experience a range of psychiatric co-morbidities, with a high prevalence of mood and anxiety disorders, trauma, eating disorders and autism spectrum conditions, suicidality and self-harm.
“Common diagnoses for children and adolescents were attention deficit disorders (transfeminine 15 per cent; transmasculine 16 per cent) and depressive disorders (transfeminine 49 per cent; transmasculine 62 per cent), respectively. For all diagnostic categories, prevalence was severalfold higher among [trans and gender-diverse] youth than in matched reference groups.”3
Gender-affirming health professionals use the concept of “minority stress” to minimise the significance and seriousness of these levels of distress—
“According to [this] model, minorities frequently experience group-specific distal stressors and proximal stressors that together create conditions of excessive stress and, in turn, adversely impact both physical and mental health through a multitude of pathways.
“Our results support much of the existing literature, and we extend these findings by identifying that [gender minority stress] plays more of a significant role in predicting psychological outcomes for this group of individuals than [gender dysphoria] (Emphasis added.)”
The possibility that mentally distressed young people may react to the pervasive and persuasive references to transgender identity—increasingly we hear of “trans joy”—on various media platforms is denied, and those who suggest this possibility are considered “anti-trans” bigots.
Where are we now?
There are complex reasons for the decline in the mental health of our youth, but one thing is clear: despite all the government support, the positive media reports, education and health services on board, access to gender-affirming care and the silencing of concerned voices, this Queer theory experiment with young people doesn’t seem to have had any significant societal benefit for them.
Add to that the rise in detransition and regret, with these young people increasingly making their voices heard, and it is time for an evaluation of the decades-long dominance of gender-affirming care.
That model of care arose from Queer theory, which, according to one commentator, “has been created by scholars with backgrounds in sociology, philosophy, law, literature or other humanities, but not in health. It is argued these ideologues regard access to gender-affirming treatments as primarily a human rights issue, rather than a mental health clinical concern.”
Moreover, “Queer theory seeks to disrupt dominant and normalizing binaries that structure our understandings of gender and sexuality.”
Translated, this suggests that gender-affirming care is as much a political statement as it is a health policy, which seems likely to explain the lack of a rigorous assessment and management protocol for gender-questioning young people.
Indeed, Florence Ashley—a transfeminine Canadian academic, activist and law professor at the University of Alberta who specialises in trans law and bioethics—is of the view that health professionals should not act as “gatekeepers” but accept the young person’s statement they are trans and give them whatever they ask for. Apparently, the matter of co-morbid mental health problems is a minor, irrelevant issue that should not trigger any red flags for the health professional.
The new standards of care (SOC-8) from the World Professional Association for Transgender Health (WPATH) promote the “informed consent” model and its easier access to treatment, rather than “gatekeeping,” which is criticised for using “‘mental readiness’ as a prerequisite to medical transition, which contributes to patient distress and systemic discrimination.”
So where does this leave health professionals? They should stick with the practice of their profession based on a long tradition of scientific research that has led to thorough and extensive knowledge about the human body and physical and mental health.
In contrast, Queer theory rests on the denial of biological reality, which, to my surprise, a significant number of gender-affirming practitioners appear to have embraced. We are told that—
“Biological sex is not as simple as male or female: It’s not just about chromosomes. Or reproductive cells. Or any other binary metric. Many genetic, environmental and developmental variations can produce what are thought of as masculine and feminine traits in the same person.”
Questions for gender clinicians
How do gender-affirming clinicians define sex? If sex isn’t about reproduction, what is it and why does it exist?
If sex isn’t related to reproduction, what is the biological function that creates a new human?
How many sexes are there? If there are more than two sexes, what are these called, and what is their function? If sex is about reproduction, what role do these other sexes play in conception?
If sex is a spectrum, how does XX slowly morph into XY and what are the intermediate gametes?
If sex is a spectrum, at what point on the sex dimension does the person change from egg producing to sperm producing?
If sex is a social construct, what are the various reproduction strategies in different societies?
How is it possible to change sex? Acknowledging that there are some genetic conditions whereby the person appears to change sex, how does an XX or XY person change sex? What is the process?
Differential diagnosis
Dr Scott Leibowitz, the co-lead author of the adolescents chapter for the latest standards of care (SOC-8) from WPATH, has described SOC-8 as “consensus- and evidence-informed clinical guidelines to help distinguish those [gender-questioning young people] who would benefit from treatment versus those who would not.”
If so, what differential diagnosis do gender-affirming clinicians use to separate those who will benefit from those who will not?
Conclusion
As we witness a rise in the number of young people who are detransitioning—whatever their reasons for doing so—gender-affirming clinicians are at increasing risk of lawsuits from former patients.
If you are such a clinician, how would you defend yourself against these claims?
Is the “but everyone else is doing it” defence plausible given that, in my view, the flaws in the theory supporting gender-affirming care should have been obvious to any health professional?
Dr Sandra Pertot retired not long ago after 50 years of practice as a clinical psychologist specialising in human sexuality, including sexual dysfunction, sexual orientation and gender diversity
The absolute number of youth suicides remains low, but this increase is concerning.
While the self-esteem movement aimed to improve well-being, some argue it may have unintentionally contributed to a rise in mental health problems by promoting a focus on self-worth that can be fragile and lead to increased vulnerability to negative self-talk and comparison.
Transfeminine refers to a biological male who identifies as female.
 | A guest post by
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Queer theory is at the heart of gender identity ideology and the attitudes, beliefs, and behaviors it has fostered.
I argue that Queer theory is not concerned with existing forms of human behavior, such as same-sex attraction. Same-sex attraction has existed for thousands of years, long before any legitimate scientific study of the phenomenon.
In contrast, the modern trans phenomenon would not exist as we know it today without Queer theory. This is because Queer theory is not designed to help trans people navigate a world that already recognizes their existence. Instead, it serves as an instruction manual for entirely new ways of thinking and being—ones without historical precedent. As ChatGPT describes it, Queer theory is "a body of intellectual work that challenges normative assumptions about gender and sexuality, particularly those rooted in heteronormativity and the binary view of sex and gender."
Put another way, the founders of Queer theory—"scholars with backgrounds in sociology, philosophy, law, literature or other humanities"—did not merely seek to analyze gender and sexuality. By constructing Queer theory from the ground up, they actively picked a fight with institutions, beliefs, and behaviors that have been fundamental to human cultures throughout history. What else is meant by the confession that “Queer theory seeks to disrupt dominant and normalizing binaries that structure our understandings of gender and sexuality"? How dare they?
There is a practical reason so many "[s]chool children are being taught in sex education classes that it is possible the doctor made a mistake, and they may not be the sex they thought they were. They are told there are more than two sexes." Without this indoctrination—and the widespread belief in gender identity theory that enables it—children would never arrive at the ABCs of gender ideology on their own.
Left to develop naturally, young people’s essential sexual orientation would begin to emerge with puberty, without any external prompting. As hormones take effect, aspects of teen culture that once seemed baffling would start to make sense.
And, quite separately, some young men might find that their burgeoning fascination with many material and behavioral manifestations of the feminine leads them to fantasize that they are themselves women. That is pretty much all trans would amount to today if Queer theory hadn't escaped from the Pandora's Box of academia and into the nurturing medium of progressive culture.
All health professionals need to do be able to ignore the risks of rights-driven medicine and the trans suicide narrative is to come together with other sex-realist/ gender-critical people and activists to expose the synthetic and pernicious nature of gender ideology.
An ABC article from May 24th 2021 praised Dr Michelle Telfer “for saving the lives of hundreds, even thousands of children – without ‘ever picking up a scalpel or treating a disease” is obviously nonsense and not particularly surprising given the ABC’s commitment to factual reporting.
The fact that it was not widely refuted by the physician mentioned says a lot.