It’s happening
Gender clinics are “transing” gay adolescents amid celebration of transgender identities and a surprising increase in homophobia especially among the young, according to Laura Edwards-Leeper, who served as the founding psychologist at America’s first specialist paediatric gender clinic.
Responding to the accusation that youth gender clinics “trans away the gay”, Dr Edwards-Leeper said this was true in some cases and it was “a major problem”.
“It took me a little while to catch on to because it was almost unbelievable … young people are suddenly not wanting to accept that people could be gay,” she said.
But she said non-gay kids were also being wrongly put on a medical path and this was “another major problem”. (She had no objection to trans identity celebration itself.)
At the “more progressive” clinics now, she said “the informed consent or assent process is really minimal … a lot of risks are not discussed, even things like fertility implications”.
Speaking on Thursday at the Washington DC conference of the Society for Evidence-Based Gender Medicine (SEGM), Dr Edwards-Leeper positioned herself between the no-medical treatment side and the no-questions affirmationists. She opposed blanket bans on paediatric medical transition but saw the need for more guardrails.
Her warnings may hit home because of her role in helping introduce the puberty blocker-driven Dutch protocol to the US. Nor can she be easily dismissed as “anti-trans”. Many of those attending the SEGM conference would be opposed to all and any paediatric medical transition.
Dr Edwards-Leeper said the pioneering gender clinic at Boston Children’s Hospital, set up in 2007 in imitation of the famous Amsterdam clinic, operated on a small scale and did not accept patients unless they had undergone external therapy for up to a year.
However, and despite their reliance on the Dutch model, the Boston team on which she was a key clinician “knew very little compared to what we know now”.
Today’s treatment practice, she said, was very different. She said her perspective drew on 20 years of clinical practice, including time spent with progressive clinics.
“The medical organisations have really shifted to this ‘affirm-without-question’ [policy] … that’s a major problem,” she said. “I also feel that departing from the established standards of care or failing to engage with relevant evidence reviews raises significant ethical concerns.”
Systematic reviews, independently commissioned in various jurisdictions internationally since 2018, have confirmed that the evidence for hormonal treatment of gender-distressed minors is very weak and uncertain. This contradicts confident claims of beneficial treatment.
Dr Edwards-Leeper said she was “not completely opposed” to the argument that the limited evidence should result in a prioritising of clinical authority and some restriction of access to medical treatment.
She said minimum ages—abandoned in the latest standards of care issued by the World Professional Association for Transgender Health (WPATH)—could be useful for a therapist.
“If the kid was 15, I could say, ‘Well, you’re too young,’ so we don’t even have to talk about that yet because it’s not on the table. So, bans aren’t necessary, in my opinion, to have the guardrails or to accomplish having good care. But we do need to have some kind of guardrails.”
Dr Edwards-Leeper served on the writing team for the adolescents chapter within the current 2022 WPATH standards for adolescents. She said she had raised concerns at the time but her influence was limited.
That chapter claimed there was not enough evidence on adolescents for a systematic review; it was later discovered that a systematic review had been commissioned then suppressed.
The minimum ages for medical interventions were abruptly abandoned after pressure from the US Biden Administration and the American Academy of Pediatrics.
Get back in your lane
At last week’s SEGM meeting, Dr Edwards-Leeper said schools were now straying “out of their lane” in an inappropriate way.
Many times she was told that a child had “first started wondering about their gender when their third-grade teacher asked everyone to think about their pronouns”.
She called for removal of the gender curriculum from schools, transparent communication with families, and “no secrecy about significant wellbeing concerns”. Parents complain of schools socially transitioning their often vulnerable children without their knowledge or consent.
In the 2010s, Dr Edwards-Leeper said, “the field [of paediatric medical transition] began to lose its way, things really started to go crazy”.
Around 2015, she said, there came a “perfect storm” with exponential growth in new, female-dominated caseloads and “no inquiry in the field as to why”. At gender clinics, the response was, “Yay, now we can treat more patients.” She said this incuriosity—not only had numbers spiked but the patient profile flipped from early-onset males to female teenagers—“blows my mind”.
“Non-binary” minors appeared on the scene, but there was “no research at all to guide” medical interventions for them.
Dr Edwards-Leeper cited the increasing time spent on the internet by minors as a key factor in the new challenges facing the gender distress field.
“I think the internet is really harming our kids [especially boys],” she said. “I can’t even begin to tell you how horrifying some of the stuff is that’s on the internet.”
She urged stronger safeguards against online grooming and predatory contact, safer gaming spaces, digital literacy, age-appropriate content and parental monitoring tools.
Along with internet use, Covid was another “major factor” in the gathering storm, she said.
Gender apostasy: In 2025, desister Simon Amaya-Price, an autistic and bisexual man, gave evidence in favour of a bill, HB377, to prohibit paediatric medical transition. That bill became law. It had been amended to allow continued use of puberty blockers and cross-sex hormones prescribed before the law took effect on January 1, 2026.
Trickle down
Another element in the “perfect storm” described by Dr Edwards-Leeper was the “trickle down” to paediatric treatment of the autonomy-first model of adult gender medicine. There arose a conflict of values about the relative importance of child autonomy and child safety.
In its extreme form, she said, the “affirmation-first” model regarded adolescents “as capable, always, of making their own decisions—autonomy is prioritised.”
“There’s an assumption that young people ‘know who they are’, and medical interventions should be viewed as acceptably safe,” she said.
“Another one that really makes my blood boil is the assumption that parents are the enemy. I don’t believe that most parents are the enemy. I think that 99 per cent of parents really deeply love their children, and want the best for them.”
Also a reason for concern was the increase in the number of minors presenting with much more complex mental health issues. Dr Edwards-Leeper said progressive clinics might regard these problems as “completely independent” of gender dysphoria or explain them away as the result of “minority stress” in a stigmatising society. Clinics began to rely less on mental health professionals, and the pre-treatment assessment process was “really watered down”.
“We need to focus on prevention more. For a lot of these kids, not all of them, it’s the online environments, the school context and their mental health needs that are leading some of them to experience gender-related distress,” she said.
“If they assume that it’s all because of gender, the gender therapist will refer them sometimes to the medical path, and that’s where we’ve got kids who are being treated who shouldn’t be.”
In her private practice, she said she offered a “comprehensive approach” individualised with an eye to a minor’s developmental stage.
In the Q&A after her talk, desister Simon Amaya-Price declared: “I was a patient at Boston Children’s. I was diagnosed with gender dysphoria when I was 14 years old, but met the diagnostic criteria for many years before then. My paediatrician asked my father while I was in the room, ‘Would you like a dead son or a living daughter?’ I’m now happy and healthy as a 22-year-old man.” (He credits his father with helping keep him off the medical path.)
Mr Amaya-Price put two questions to Dr Edwards-Leeper—Firstly, “What is a transgender person, and what evidence for their existence exists besides self-report data?”
Secondly, “What evidence would you need to see to convince you that all paediatric transition is inappropriate, or is this your white whale?”
In reply, she conceded that trans identity rested on self-report. “What I do see in my practice is people who do benefit from medical interventions, and so that’s more important to me than whether they truly are trans or something like that.”
On the second question, she said: “If the number of appropriately screened and evaluated young people who had gone through mental health therapy first, had been thoroughly assessed prior to starting any kind of medical interventions, had given informed consent and their parents had as well … if a sizeable number of them started expressing regret, then I would have major concerns.”
Mr Amaya-Price, who began identifying as female around age 14 after severe bullying and sexual assault, now runs the Detransitioner Justice Project. Detransitioner Claire Abernathy handles communications for the project.
Child Suicide in Australia: A Disturbing Disparity in Medical Concern:
Australia's gender physicians constantly remind us of the threat of suicide among children experiencing gender dysphoria and the equally questionable claim that their gender-affirming treatment is saving lives.
I am unable to identify a documented Australian child suicide attributed to gender dysphoria, and I don’t believe that there is any evidence that medical transition prevents suicide. In fact, multiple post-transition studies confirm that suicide rates are elevated. The well documented Swedish post transition study indicated a suicide rate 19 times that of matched controls; hardly reassuring and I suspect that parents and children waiting in the queue are not made aware of such realities as part of mandatory informed consent.
Meanwhile, the child suicide elephant in the room is the documented and profoundly disproportionate suicide toll among Australia’s Indigenous children.
The Australian Bureau of Statistics figures reveal a disturbing disparity:
• Indigenous children aged 5–17: 5.2 suicides per 100,000 annually (2020–2024).
• Same age non-indigenous children: 1.9 suicides per 100,000 over the same period.
• Indigenous children therefore experienced approximately 2.7 times the suicide rate of their non-Indigenous counterparts.
• The latest ABS figures (October 2026) record 68 Indigenous child suicides during 2021–2025, with a rate of 5.0 per 100,000.
Australia's medical professionals appear obsessed with the inadequately quantified threat of suicide among the GD cohort, yet seemingly less vocal about the documented and disproportionately high suicide toll among Indigenous children?
Surely medical advocacy should reflect reliable evidence, the scale of preventable harm and genuine public health priorities.