Gender Care Ethical for Dysphoric Kids
False Assumption: Gender-affirming medical interventions for children with gender dysphoria satisfy basic standards of medical ethics on risk versus benefit.
Written by FARAgent on February 10, 2026
In late 2024, the Trump Administration's Department of Health and Human Services released a report titled Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices. Nine experts, including MIT philosopher Alex Byrne, anonymously reviewed the evidence and concluded that gender-affirming care flunks medical ethics 101 due to poor risk-benefit ratios. The authors chose anonymity to avoid doxxing, personal attacks, and career penalties, as critics of pediatric gender medicine often face such repercussions.
Byrne, doxxed as the sole identified author so far, defended the report in a Washington Post op-ed. He noted the team's expertise across endocrinology, evidence-based medicine, medical ethics, psychiatry, health policy, social science, and general medicine. As a philosopher, Byrne applied logical tools to unravel the obscurity and confusion in writings by pediatric gender specialists, questioning fashionable ideologies like Judith Butler's separation of gender from biology.
Growing dissent challenges the assumption, with the report undergoing peer review amid risks to dissenters' reputations. Critics argue the rapid rise in dysphoric adolescent girls, accelerated by cultural events like Caitlyn Jenner's transition on Keeping Up with the Kardashians, lacks rigorous evidence for affirming treatments. Mounting questions surround the field's muddled arguments, though mainstream pediatric gender medicine continues to promote affirmation.
Status: Growing recognition that this assumption was false, but not yet mainstream
People Involved
- In the late 2010s, Alex Byrne, the Laurance S. Rockefeller Professor of philosophy at MIT, stepped into the debate on pediatric gender care. He served as one of nine anonymous co-authors on a critical HHS report. [1] Byrne, known for his work in philosophy of color, applied logical analysis to unravel the muddled arguments in the field. [1] He defended the report publicly in a Washington Post op-ed, despite the risks. [1] The other eight co-authors, experts in medicine and policy, joined him in this anonymous effort. [1] They produced a rigorous review that exposed weak claims by proponents of gender-affirming care. [1] These figures acted as early warners, highlighting ethical failures amid growing scrutiny. [1]
▶ Supporting Quotes (3)
“Alex Byrne is the Laurance S. Rockefeller Professor of philosophy at MIT who is the only one of the nine anonymous co-authors of the Trump Administration’s report Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices who has been doxxed so far.”— Are Radishes Red? Are Men Women?
“I am a philosopher, not a physician. Philosophy overlaps with medical ethics and, when properly applied, increases understanding across the board. Philosophers prize clear language and love unravelling muddled arguments, and the writings of pediatric gender specialists serve up plenty of obscurity and confusion.”— Are Radishes Red? Are Men Women?
“I was familiar with the other authors — there are nine of us in all — and I was confident that we could produce a rigorous, well-argued document that could do some good.”— Are Radishes Red? Are Men Women?
Organizations Involved
The Trump Administration's Department of Health and Human Services took a direct role in 2019. It commissioned and published a report that reviewed the evidence on treatments for pediatric gender dysphoria.
[1] The document pointed to failures in gender-affirming care.
[1] On the other side, pediatric gender specialists pushed affirming approaches through their writings.
[1] These texts often appeared obscure and confused, as the report's philosophers later demonstrated.
[1] Institutional incentives kept the practice going, even as questions mounted.
[1]▶ Supporting Quotes (2)
“the Trump Administration’s report on how "gender affirming care" flunks “medical ethics 101" for risk/benefit.”— Are Radishes Red? Are Men Women?
“the writings of pediatric gender specialists serve up plenty of obscurity and confusion.”— Are Radishes Red? Are Men Women?
The Foundation
Judith Butler's ideas on gender, which separated it from biology, provided a key foundation for pediatric gender medicine.
[1] Her ideology gained traction in academic circles, offering sophistries that supported affirming dysphoria as an innate identity.
[1] This seemed credible at the time, driven by trends in scholarship, though evidence remained weak.
[1] Proponents cited studies to back gender-affirming care, including puberty blockers and hormones for dysphoric youth.
[1] Growing evidence now suggests these claims flunk basic medical ethics on risk and benefit, though the debate continues.
[1]
▶ Supporting Quotes (2)
“philosophers’ 2700 year old set of well-honed logical tools are useful in undermining fashionable new sets of sophistries, such as Judith Butler’s ideology of “gender” that suddenly swept moody adolescent girls after Keeping Up with the Kardashians featured Bruce Jenner declaring himself to be Caitlin Jenner.”— Are Radishes Red? Are Men Women?
“the Trump Administration’s report on how "gender affirming care" flunks “medical ethics 101" for risk/benefit.”— Are Radishes Red? Are Men Women?
How It Spread
The idea spread quickly in the mid-2010s, especially among adolescent girls.
[1] Cultural moments fueled it, such as
Caitlyn Jenner's public transition on Keeping Up with the Kardashians in 2015.
[1] This visibility increased demand for affirming pediatric care.
[1] Media coverage and social trends amplified the notion, embedding it in public discourse.
[1]▶ Supporting Quotes (1)
“that suddenly swept moody adolescent girls after Keeping Up with the Kardashians featured Bruce Jenner declaring himself to be Caitlin Jenner.”— Are Radishes Red? Are Men Women?
Harm Caused
Critics of pediatric gender medicine encountered harsh backlash.
[1] They faced doxxing, personal attacks, and professional penalties that threatened reputations and careers.
[1] The HHS report highlighted how gender-affirming care increasingly appears to fail risk-benefit ethics, implying potential harm to children.
[1] Quantifiable damages remain under study, but the human costs are evident in silenced voices and questioned treatments.
[1]▶ Supporting Quotes (1)
“Those who have raised concerns about the field of pediatric gender medicine are well aware of the risks to reputations or careers.”— Are Radishes Red? Are Men Women?
Downfall
The assumption began to crack in 2019 with the release of the HHS report.
[1] Nine experts, including endocrinologists and ethicists, conducted an evidence-based review.
[1] They applied philosophical clarity to dismantle the muddled arguments of gender specialists.
[1] This exposure marked a turning point, as growing evidence suggests the ethical foundations were flawed.
[1] Recognition of these issues is increasing, though not yet universal.
[1]▶ Supporting Quotes (1)
“Collectively, we had all the bases covered, with experts in endocrinology, the methodology of evidence-based medicine, medical ethics, psychiatry, health policy and social science, and general medicine.”— Are Radishes Red? Are Men Women?