This is a lucid, meticulous, and long-overdue corrective to the mythology surrounding pediatric gender medicine and the judicial challenges to its regulation. Lane's account does more than report the Skrmetti ruling — it places it squarely within the larger arc of democratic accountability, medical ethics, and transatlantic policy convergence.
Especially welcome is the attention paid to the Court’s rejection of the claim that trans identification should trigger strict or intermediate scrutiny. As Lane documents, both Justice Barrett and Justice Alito dismantle the claim that trans status functions like race or sex in equal protection analysis. Their reasoning underscores how ill-suited the framework of “civil rights” is to a field characterized by ideological fluidity, medically irreversible interventions, and contested science.
Lane also excels in foregrounding the international repudiation of WPATH’s authority. His coverage of Justice Thomas’s concurrence, with its evisceration of WPATH’s circular referencing and its exposure of politicized guideline manipulation, is essential reading. That Thomas cited the Cass Review’s damning conclusion — that what appears to be a global medical consensus is largely a Potemkin village — was a watershed moment, and Lane gives it the weight it deserves.
Equally important is the essay’s emphasis on the ethical and epistemic failures of the gender medicine establishment: the dubious practice of presenting off-label hormonal interventions as routine care; the lack of informed consent from minors; the erasure of detransitioners; and the weaponization of suicide risk as a form of emotional coercion. Lane threads these arguments together into a powerful indictment of eminence-based medicine dressed up as evidence-based care.
This piece is what legacy media outlets should be publishing but won’t: a factual, calm, and deeply sourced treatment of an issue too often obscured by slogans, fear-mongering, and the rhetorical flattening of “trans rights.” Instead of repeating activist tropes, Lane treats the reader as capable of reasoned engagement with medical risk, democratic process, and constitutional law. A triumph.
Hi Ollie, that is a lovely comprehensive yet concise summary of Bernard's fantastic report on the Supreme Court Judgment. Could I use it on our CAN-SG website where I hope to post Bernard's article?
CAN-SG is the Clinical Advisory Network on Sex and Gender, a UK clinicians network that is concerned about sex and gender in health and health care.
That the judges actually took into account the Cass Review, the WPATH files and detransitioner stories - incredible! Their thoughtful conclusions make for fantastic reading for those of us who have had to listen to the activists dominating the official narrative for so long.
Thank you for your amazing work, Bernard! Surely politicians in Australia will start waking up now?
I would not be confident that our Federal Health Minister, Mark Butler, will have a great deal of insight into health issues. His only pre-parliamentary employment was that of a Union Official from 1992 - 2007, fifteen years!
Very detailed article. It seems that Judge Sotomayr had only emotive arguments that say nothing about the long term consequences of such radical treatment.
We are constantly reminded by the experts that without appropriate and timely intervention (that being the Affirmative Moder of Gender Care) there exists a significant risk that children with gender dysphoria will suicide.
I wondered if this were true and checked some of the most recent studies but could find no evidence of a single child gender dysphoria related suicide. Surprisingly however what I did find was pretty much the opposite: Suicides and suicidality of individuals following gender ‘transition’. Those poor souls who ticked all the ‘suicide prevention boxes’ were suiciding.
I briefly reference three of numerous recent studies that reflect this reality:
The first is from the Karolinska Group (Interestingly, the Karolinska University Hospital in Sweden played a significant role in the history of addressing gender dysphoria, particularly in the context of hormonal and surgical interventions for minors (they no longer promote such interventions))
• Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden’, 2011 Feb 22;
A population-based matched cohort study. Sweden, 1973-2003.
Conclusions: Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.
• Risk of Suicide & Self-Harm Following Gender-Affirmation Surgery. Cureus 2024 April
Conclusion: Patients who have undergone gender-affirming surgery are associated with a significantly elevated risk of suicide.
• Examining gender-specific mental health risks after gender-affirming surgery: a national database study. Journal of Sexual Health Medicine 4, April 2025
Conclusions: From 107583 patients, matched cohorts demonstrated that those undergoing surgery were at significantly higher risk for depression, anxiety, suicidal ideation and substance use disorders than those without surgery.
Gender Dysphoria aside, there is a very real child suicide epidemic that requires attention:
In the first month of 2019, 5 Aboriginal girls, aged 12–15 years, have taken their own lives and a 12-year-old boy is critically ill after attempted suicide. Indigenous children (5–17 years old) in Australia die from suicide at five times the rate of their non-Indigenous peers (ref: the Lancet)
This is a lucid, meticulous, and long-overdue corrective to the mythology surrounding pediatric gender medicine and the judicial challenges to its regulation. Lane's account does more than report the Skrmetti ruling — it places it squarely within the larger arc of democratic accountability, medical ethics, and transatlantic policy convergence.
Especially welcome is the attention paid to the Court’s rejection of the claim that trans identification should trigger strict or intermediate scrutiny. As Lane documents, both Justice Barrett and Justice Alito dismantle the claim that trans status functions like race or sex in equal protection analysis. Their reasoning underscores how ill-suited the framework of “civil rights” is to a field characterized by ideological fluidity, medically irreversible interventions, and contested science.
Lane also excels in foregrounding the international repudiation of WPATH’s authority. His coverage of Justice Thomas’s concurrence, with its evisceration of WPATH’s circular referencing and its exposure of politicized guideline manipulation, is essential reading. That Thomas cited the Cass Review’s damning conclusion — that what appears to be a global medical consensus is largely a Potemkin village — was a watershed moment, and Lane gives it the weight it deserves.
Equally important is the essay’s emphasis on the ethical and epistemic failures of the gender medicine establishment: the dubious practice of presenting off-label hormonal interventions as routine care; the lack of informed consent from minors; the erasure of detransitioners; and the weaponization of suicide risk as a form of emotional coercion. Lane threads these arguments together into a powerful indictment of eminence-based medicine dressed up as evidence-based care.
This piece is what legacy media outlets should be publishing but won’t: a factual, calm, and deeply sourced treatment of an issue too often obscured by slogans, fear-mongering, and the rhetorical flattening of “trans rights.” Instead of repeating activist tropes, Lane treats the reader as capable of reasoned engagement with medical risk, democratic process, and constitutional law. A triumph.
Hi Ollie, that is a lovely comprehensive yet concise summary of Bernard's fantastic report on the Supreme Court Judgment. Could I use it on our CAN-SG website where I hope to post Bernard's article?
CAN-SG is the Clinical Advisory Network on Sex and Gender, a UK clinicians network that is concerned about sex and gender in health and health care.
I would be delighted!
That the judges actually took into account the Cass Review, the WPATH files and detransitioner stories - incredible! Their thoughtful conclusions make for fantastic reading for those of us who have had to listen to the activists dominating the official narrative for so long.
Thank you for your amazing work, Bernard! Surely politicians in Australia will start waking up now?
Thank you once again for your brilliant reporting Bernard. This is a very significant decision. Justice Thomas’ comments are particularly insightful.
I hope Mr Butler’s review will take them into account.
I would not be confident that our Federal Health Minister, Mark Butler, will have a great deal of insight into health issues. His only pre-parliamentary employment was that of a Union Official from 1992 - 2007, fifteen years!
Very detailed article. It seems that Judge Sotomayr had only emotive arguments that say nothing about the long term consequences of such radical treatment.
It is a good judgement and very welcome.
SOME FACTS - AFFIRMATION AND SUICIDE
We are constantly reminded by the experts that without appropriate and timely intervention (that being the Affirmative Moder of Gender Care) there exists a significant risk that children with gender dysphoria will suicide.
I wondered if this were true and checked some of the most recent studies but could find no evidence of a single child gender dysphoria related suicide. Surprisingly however what I did find was pretty much the opposite: Suicides and suicidality of individuals following gender ‘transition’. Those poor souls who ticked all the ‘suicide prevention boxes’ were suiciding.
I briefly reference three of numerous recent studies that reflect this reality:
The first is from the Karolinska Group (Interestingly, the Karolinska University Hospital in Sweden played a significant role in the history of addressing gender dysphoria, particularly in the context of hormonal and surgical interventions for minors (they no longer promote such interventions))
• Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden’, 2011 Feb 22;
A population-based matched cohort study. Sweden, 1973-2003.
Conclusions: Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.
• Risk of Suicide & Self-Harm Following Gender-Affirmation Surgery. Cureus 2024 April
Conclusion: Patients who have undergone gender-affirming surgery are associated with a significantly elevated risk of suicide.
• Examining gender-specific mental health risks after gender-affirming surgery: a national database study. Journal of Sexual Health Medicine 4, April 2025
Conclusions: From 107583 patients, matched cohorts demonstrated that those undergoing surgery were at significantly higher risk for depression, anxiety, suicidal ideation and substance use disorders than those without surgery.
Gender Dysphoria aside, there is a very real child suicide epidemic that requires attention:
In the first month of 2019, 5 Aboriginal girls, aged 12–15 years, have taken their own lives and a 12-year-old boy is critically ill after attempted suicide. Indigenous children (5–17 years old) in Australia die from suicide at five times the rate of their non-Indigenous peers (ref: the Lancet)
I submit that transgenderism is often a manifestation of mental illness, so these findings are not unexpected.
Thanks for that. Helpful information.