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.

Summaries Written by FARAgent (AI) on February 10, 2026 · Pending Verification

For much of the 2010s, the governing assumption in pediatric gender medicine was that "gender-affirming care" met ordinary medical ethics because the likely benefits outweighed the risks. That view did not come from nowhere. Clinicians were seeing distressed adolescents, often saying that puberty felt intolerable, and the Dutch protocol offered a seemingly orderly model: pause puberty, reduce suffering, then consider hormones. Professional groups and major media repeated the same points, that this care was "medically necessary," "evidence-based," and in some cases "lifesaving." A reasonable person, looking at small early studies, expert guidelines, and the urgent fear of suicide, could conclude that timely intervention was the humane and ethical course.

Over time, the evidentiary basis for that confidence came under heavier scrutiny. Systematic reviews in Europe, culminating in the Cass Review in Britain, found the evidence for puberty blockers and cross-sex hormones in minors to be weak, with poor controls, short follow-up, and uncertain long-term outcomes. Sweden, Finland, and England moved toward tighter limits after reviews questioned whether benefits on mental health had been shown clearly enough to justify risks such as infertility, sexual dysfunction, impaired bone density, and loss of future reproductive options. Critics also pointed to whistleblower accounts, detransitioner testimony, and disputes over studies said to show reduced suicidality or improved well-being. Supporters, for their part, still cite observational studies, clinical experience, and the claim that withholding treatment can deepen distress in carefully selected patients.

The debate now is not whether these interventions are serious medicine, but whether they satisfy the usual ethical tests for children: informed consent, proportionality, and solid evidence of benefit. Growing evidence suggests many experts no longer think the old assurances were earned, at least not in the broad and confident form in which they were often presented. Yet influential medical bodies in the United States continue to defend gender-affirming care under specialist supervision, and many clinicians argue that the answer is better assessment, not abandonment. So the assumption remains increasingly questioned rather than settled, with the argument turning on a plain issue: how much uncertainty medicine may tolerate before it stops calling a pediatric intervention ethical.

Status: A small but growing and influential group of experts think this was false

People Involved

Alex Byrne, Laurance S. Rockefeller Professor of Philosophy at MIT, co-authored the 2025 HHS report as one of nine anonymous experts while publicly defending its conclusions in a Washington Post op-ed despite professional risks. A philosopher known for work on color and perception, he applied rigorous logical analysis to the muddled arguments underpinning pediatric gender medicine and acted as a cassandra warning of ethical shortfalls. His involvement helped unravel claims that had guided clinical practice for over a decade. ^[1]
Dr. Hilary Cass, a respected British pediatrician, chaired the 2024 independent review commissioned by NHS England that systematically assessed the evidence for youth gender interventions and found it remarkably weak. Her report prompted England to restrict puberty blockers to research settings only and contributed to international re-evaluations. Cass became a central figure in the growing challenge to earlier assumptions about benefits outweighing risks. ^[6][59]
Johanna Olson-Kennedy, medical director of the largest U.S. youth gender clinic at Children’s Hospital Los Angeles, led federally funded studies on puberty blockers and hormones yet admitted withholding unfavorable puberty blocker data for political reasons. She referred patients like Clementine Breen for blockers on the first visit with minimal prior therapy and co-authored critiques of the Cass Review while serving as a paid expert witness defending such care. Her actions exemplified the institutional commitment to the assumption even as evidence questions mounted. ^[22][55][28]
Paul R. McHugh, former psychiatrist-in-chief at Johns Hopkins, halted gender transition surgeries there in the 1970s after reviewing outcomes and later warned that the field rested on weak evidence and ideological rather than medical foundations. His early skepticism positioned him as a cassandra whose views gained renewed attention as European countries began restricting youth interventions. ^[10]

▶ Supporting Quotes (142)

“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?

“Based on the HHS review, healthcare providers caring for children and adolescents with gender dysphoria should: 1. Refuse to provide puberty blockers, cross-sex hormones, or surgical interventions to children and adolescents”— Message Pediatric Gender Dysphoria Treatment

“Christopher Gillberg: Conceptualization, Data curation, Methodology, Supervision, Validation, Writing – review & editing”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“the 2024 Independent Review of Gender Identity Services for Children and Young People: Final Report commissioned by NHS England and authored by Dr. Hilary Cass.”— Position Statement on Gender Surgery for Children and Adolescents

“Laura L. Kimberly, MSW, MBE a Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York, New York”— Ethical Issues in Gender-Affirming Care for Youth

“Aron Janssen, MD f Department of Child and Adolescent Psychiatry, and New York University School of Medicine, New York, New York”— Ethical Issues in Gender-Affirming Care for Youth

“others consider it to be unethical (American College of Pediatricians 2023; Laidlaw, Cretella and Donovan 2019; Levine, Abbruzzese and Mason 2022a; Van Meter 2019).”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“Mia Hughes, author of The WPATH Files – an exposé of the World Professional Association of Trangender Health’s transformation into a politically driven entity.”— Transsexualism is pseudoscience

“Dr. Paul R. McHugh, arguably the most important American psychiatrist of the last half-century”— Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences

“As Helen Lewis points out in The Atlantic, there has been a powerful “liberal misinformation bubble” surrounding youth gender medicine.”— How to Confront Highbrow Misinformation

“The claims have been led by the legal campaign group the Good Law Project, who are challenging the decision by the previous Health Secretary to end the prescription of puberty-blocking drugs by private clinics to children and young people with gender dysphoria. The central claim, made on X (formerly known as Twitter), is that there has been a large rise in suicide by current and recent patients of the Gender Identity Development Service (GIDS) service at the Tavistock since an earlier restriction of puberty-blocking drugs that followed a High Court decision in a case (Bell v Tavistock) in December 2020.”— Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report

“This claim is said to be based on unpublished data provided by 2 members of staff at the Tavistock, described as whistleblowers. On Twitter/X the evidence is presented in screenshots of extracts from the records of Tavistock Board meetings and other documents. These variously refer to suicides, deaths from unspecified causes and “safety incidents”. [...] The whistleblowers are said to have alleged a cover-up by NHSE.”— Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report

““We found low and very low certainty evidence suggesting improvements in gender dysphoria, depression, anxiety, and quality of life, as well as low rates of adverse events, after treatment with puberty blockers and cross-sex hormones.””— AHCA: About AHCA

““The research importantly distinguishes completed suicides—which occur primarily in biological males and involve the intent to die—from suicidal ideation, gestures, and attempts—which occur primarily in biological females and represent psychological distress and cries for help. The evidence is minimally consistent with transphobia being the predominant cause of suicidality. The evidence is very strongly consistent with the hypothesis that other mental health issues, such as Borderline Personality Disorder (BPD), cause suicidality and unstable identities, including gender identity confusion.””— AHCA: About AHCA

““The international consensus of public health care services is that there remains no evidence to support medicalized transition for youth. The responses in the U.S. stand in stark contrast with Sweden, Finland, France, and the United Kingdom, which are issuing increasingly restrictive statements and policies, including bans on all medical transition of minors.””— AHCA: About AHCA

““The claim is made that chest masculinization has proven benefit in reducing dysphoria and the associated risk of suicide. But published studies that make this claim of benefit offer evidence that is low to very low quality.””— AHCA: About AHCA

““Until we can demonstrate the efficacy and safety of any proposed treatment or intervention, its usage must properly be considered a medical experimentation and require fully informed consent. Anything less is a betrayal of both our principles and our progeny.””— AHCA: About AHCA

“first posited by Dr. Lisa Littman in 2018”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“The new study, co-authored by Suzanna Diaz and J. Michael Bailey”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“At the demand of activist researchers, Littman’s paper was subjected to a rare second round of post-publication peer review.”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“Clearly Howard is confident in the evidence base for gender medicine. And the study he links the word evidence to happens to concern an area I know a fair bit amount: youth gender medicine.”— How Can Doctors Like This Provide Competent Care To Their Patients?

“On top of all that, the leader of this research team, Johanna Olson-Kennedy, later admitted that her team withheld its data on puberty blockers for political reasons”— How Can Doctors Like This Provide Competent Care To Their Patients?

“The Dutch researchers who invented youth gender medicine wrote that they thought experiencing the first bit of puberty could help to clarify things.”— Your December Questions, Answered (1 of 2)

“authored by the law professors Daniel G. Aaron of the University of Utah and Craig Konnoth of the University of Virginia. (Aaron is also a physician.)”— If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes

““The results were very dramatic. We had a 56.7% baseline rate of depression, and a 43.4% baseline rate of suicidality – but receipt of any form of gender-affirming care, either or [sic] the puberty blockers or the gender-affirming hormones, was associated with a 60% reduction in depression and a 73% reduction in suicidality.””— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“Diana Tordoff discussed her and her colleagues’ findings on Science Friday, a very popular weekly public radio science show, not long after the study was published.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

““We must be prepared to defend the idea that, in principle, everyone should have access to sex-changing medical care, regardless of age, gender identity, social environment, or psychiatric history,” argues Chu.”— Andrea Long Chu’s ‘New York’ Cover Story About Trans Kids Is, Above All Else, Lazy

“In 2018, The Atlantic published a long cover story by the reporter Jesse Singal called “When Children Say They’re Trans,” focusing on the clinical disagreements over how to treat gender-questioning youth.”— Andrea Long Chu’s ‘New York’ Cover Story About Trans Kids Is, Above All Else, Lazy

“As the decade progressed, though, a new understanding took hold: that trans kids “know who they are” and that there’s therefore little reason to delay social transition. With the cultural tides shifting, an increasing number of parents followed suit and transitioned young kids — in some cases, as young as age 3.”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

““The results are exactly what I said was going to happen back in 2018 and in subsequent writings,” said Dr. Kenneth Zucker, a clinical psychologist and sex researcher in Toronto.”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

““The longer the observation the greater the instability!!!” said Dr. Stephen Levine, a psychiatry professor at Case Western Reserve University School of Medicine who has been working with and researching trans adults and youth for decades, said in an email.”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“Edwards-Leeper also noted that a nonbinary gender identity might just be a way station, of sorts, on the way toward some of these kids reidentifying with their birth sex.”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“Olson-Kennedy first saw Breen late in December of 2016, and during that first appointment, according to her visit notes, she referred Breen for puberty blockers. Olson-Kennedy noted that at that point, Breen hadn’t yet seen a therapist, but that her parents had.”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“That therapist was Susan P. Landon. Breen’s parents saw her earlier that same month. Landon was not an independent, third-party voice in all this; rather, she co-chairs a trans youth support group called Transforming Family with Olson-Kennedy and Dr. Aydin Olson-Kennedy, a trans man and social worker who is married to Johanna.”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“The paper’s lead author, Meredithe McNamara, is an adolescent medicine physician at Yale Medical School who has carved out a very prominent role in the national conversation.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“Janssen and Olson-Kennedy are longtime youth gender medicine providers... Turban is a younger gender clinician... multiple studies published by Turban were rated as low quality by the Cass team’s systematic reviewers.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“Olson-Kennedy ($200 per hour), and Turban ($400 or $250 per hour, depending on the task) have all received money as expert witnesses in cases fighting bans or restrictions of youth gender medicine.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“One of Turban’s studies (footnote 53) was deemed low quality in the SR on puberty blockers; another (footnote 65) was deemed low quality in the SR on hormones.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“It was published by The Integrity Project, a Yale Law School center co-founded by Meredithe McNamara, an adolescent medicine physician at Yale, and Anne Alstott, a legal scholar at Yale Law School, and lead-authored by Meredithe McNamara.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“this is an important document, because it reflects the views of some of the top youth gender medicine clinicians and researchers in the country — experts who are frequently quoted and consulted on this issue — including Johanna Olson-Kennedy, Jack Turban, Kellan Baker, and Aron Janssen.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“co-founded by Meredithe McNamara, an adolescent medicine physician at Yale, and Anne Alstott, a legal scholar at Yale Law School... When I reached out, Alstott claimed that this was a version-control error”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“That paper, published by Yale Law School’s Integrity Project (and promoted by the law school itself), was co-authored by Meredithe McNamara, Kellan Baker, Kara Connelly, Aron Janssen, Johanna Olson-Kennedy, Ken C. Pang, Ayden Scheim, Jack Turban, and Anne Alstott.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“Olson-Kennedy was recently sued by a former patient who has detransitioned and who claims that she was quickly pushed toward physical interventions she now regrets (Olson-Kennedy’s own notes support this former patient’s account).”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“I interviewed the episode’s lead presenter, Carolina Jemsby, a Swedish investigative jour…”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“"It's so important for the healthcare workers in this field to not become activists."”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

““We do start to worry about the effects of hormone blockers on the bones during a time [young people] should be having rapid accretion of calcium into the bones,” said Daniel Metzger, a pediatric endocrinologist at BC Children’s Hospital in Vancouver, who helped establish that hospital’s protocols for youth transition.”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

““We start puberty blocking around the age of 10-12 and start hormones around the age of 15,” said Anna van der Miesen, a clinician at the Gender Identity Clinic at the VU University Medical Center in Amsterdam... “A hard ban of 18 years would I think undermine the possibilities of individualized gender care.””— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

““As those of us doing youth work with transgender and gender creative kids know the use of ages rather than stages (development) is fundamentally misguided. All youth care involves parental consent... to allow legislators to determine what is best for kids is just as onerous as allowing legislatures to decide adult medical care.””— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“Placing an arbitrary age cap for transgender adolescents who need medical care is not only a poorly thought out idea that runs counter to the [World Professional Association for Transgender Health] Standards of Care and [other] clinical guidelines, but I have no doubt that this would put a group of young people who are already at increased risk of severe mental health issues, including suicide risk, at an even greater risk.”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

““The Science of Transgender Treatment” by Novella and Gorski themselves”— How Science-Based Medicine Botched Its Coverage Of The Youth Gender Medicine Debate

“a favorable review of Abigail Shrier’s book Irreversible Damage: The Transgender Craze Seducing Our Daughters by Dr. Harriet Hall, a longtime contributor to SBM who has written more than 700 articles for the site”— How Science-Based Medicine Botched Its Coverage Of The Youth Gender Medicine Debate

“the change in youth GD referral patterns was sufficiently concerning to Annelou de Vries[, a leading clinicians at the Dutch youth-gender clinic that came up with the puberty-blocking protocol ] that she wrote a 2020 commentary in Pediatrics suggesting the emergence of a ‘new developmental pathway… involving youth with post-puberty adolescent-onset transgender histories’. ‘This raises the question whether the positive outcomes of early medical interventions also apply to adolescents who more recently present in overwhelming large numbers for transgender care, including those that come at an older age, possibly without a childhood history of [gender dysphoria],’ she wrote.”— How Science-Based Medicine Botched Its Coverage Of The Youth Gender Medicine Debate

““Abigail Shrier’s Irreversible Damage: A Wealth of Irreversible Misinformation” by Rose Lovell”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“Eckert includes in their critique of Irreversible Damage references to several quotes that don’t appear anywhere in it — that is, quotes that are made-up (some but not all of which have been corrected).”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“the site’s founder and executive editor, Steven Novella, and its managing editor, David Gorski.”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“Ray Blanchard was never removed from a position (as he confirmed to me in an email), so I’m not sure what she’s even referring to here.”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“In the course of firing Zucker and shuttering his clinic, the hospital that employed him did, in fact, publicly libel him, as that hospital subsequently acknowledged in a hefty cash settlement accompanied by an apology.”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

““Our results provide a strong scientific basis that gender-affirming care is crucial for the psychological well-being of our patients,” said Garofalo, one of the principal investigator for the study, as well as co-director of the youth gender clinic at Lurie Children’s Hospital, in a press release published out by the hospital.”— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

““The critical results we report demonstrate the positive psychological impact of gender-affirming hormones for treatment of youth with gender dysphoria,” added Olson-Kennedy, Medical Director of the Children's Hospital Los Angeles clinic.”— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

“As Michael Biggs, a sociology professor at Oxford University and a frequent critic of youth gender research, pointed out to me, this figure was about 317 suicide deaths per 100,000 patient-years”— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

“[Turban:] No”— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“Zukerman is clearly saying that if you, the parent listening, have a kid who wants to go on hormones, and you don’t put them on hormones, you risk raising the probability they will become suicidal and/or attempt suicide.”— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“we got in contact with different people who were all telling a story... about a lot of teenage girls... that were seeking transgender healthcare... many of these girls were actually detransitioning later on.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“Zack Ford of ThinkProgress, for example, that publication’s leading authority on trans issues, once told me via Twitter that “The research that informs desistance is bunk. IF desistance exists, we have nothing currently available to substantiate it as a claim.””— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“Plenty of other desistance skeptics have made similarly strong claims, and have rarely backed them with much evidence. Ford’s article links to what is probably one of the most widely circulated such articles, “The End of the Desistance Myth,” written by the leading trans activist Brynn Tannehill.”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

““The Struggles of Rejecting the Gender Binary” goes the headline. The subhead: “Not everyone identifies as male or female. This is what it’s like to be nonbinary in a world that wants to box you in.” The article is mostly about nonbinary young people seeking out hormones or surgery.”— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“For the next minutes, Salem tried to criticize Tate, to lash out at her, for failing to help them enough, and Tate encouraged the effort. But quickly Salem fell mute. Body utterly still, they withdrew further and further, the glaze of their eyes clouding, until Tate felt that her client was in a state of dissociation... Under these circumstances, Salem has gone on hormones.”— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“many clinicians believe exploration is key to good outcomes. If a young natally male person says to a psychologist “I’m not really a boy — I’m a girl,” a good clinician will help them explore, in a compassionate way, what it means to them to be a girl.”— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“A New Jersey-based therapist in her 50s, who describes herself as a butch lesbian and who has worked with nearly two dozen nonbinary high school and college students, is more circumspect. She guessed that many of her assigned-female nonbinary clients would once have lived as butch or — a subcategory — stone butch lesbians. “Are we just being faddish in the wish for more and more individualized identities?””— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“I don’t think this is an accurate summary of the Times piece at all. It isn’t true that Sohn’s “entire story” highlights the downsides — it explains clearly and accurately why there are benefits to binding.”— Is The Process Of Science Reporting Inherently Transphobic?

“Erica Anderson, a psychologist at the UCSF Child and Adolescent Gender Center Clinic who is herself trans, pointed out some of the problems that could be introduced by this sort of top-down state control over medical practice: "As those of us doing youth work with transgender and gender creative kids know the use of ages rather than stages (development) is fundamentally misguided."”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“Placing an arbitrary age cap for transgender adolescents who need medical care is not only a poorly thought out idea that runs counter to the [World Professionatl Association for Transgender Health] Standards of Care and [other] clinical guidelines, but I have no doubt that this would put a group of young people who are already at increased risk of severe mental health issues, including suicide risk, at an even greater risk.”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“under current guidelines gender-affirming hormones such as testosterone and estrogen are not even prescribed for children under the age of 16 and puberty blockers are not recommended until a child reaches adolescence.”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“here’s a paragraph that jumped out at me from Jack Turban’s otherwise reasonable article... We no longer consider gender diversity to be an illness.”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“This one is a bit more in-depth. It’s from a piece by Katelyn Burns on the aforementioned Texas case that gets many, many basic things wrong on multiple fronts.”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“Written by the UC - Berkeley English professor Grace Lavery, a trans woman, it’s headlined “A High Court Decision in Britain Puts Trans People Everywhere at Risk.””— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

“After a very long hassle of a process, Foreign Policy finally agreed with most of my suggestions and updated/corrected the article on February 2nd”— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

“Johanna Olson-Kennedy, an adolescent medicine physician at the Children’s Hospital of Los Angeles who is an enthusiastic and well-known proponent of youth gender medicine.”— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

““My opinion is SEGM has no respect for autonomy, that they take the position that we should ban the procedures, that patients should not be able to access them, and I have big problems with that.””— The Disaster At McMaster Part 2: My Interview With Gordon Guyatt

“HEI’s superstar scholar is Gordon Guyatt, who is considered one of the godfathers of EBM. Guyatt introduced the term itself in 1991... Gordon Guyatt, MD, MSc”— The Disaster At McMaster, Part 1

“These efforts were led by Romina Brignardello-Petersen, an experienced McMaster scholar... Romina Brignardello-Petersen, DDS, MSc, PhD”— The Disaster At McMaster, Part 1

“ask about Olson-Kennedy withholding a report she was commissioned because of political reasons”— (Some Of) Your July 2025 Questions, Answered

“or Levine’s intervention in WPATH guidelines”— (Some Of) Your July 2025 Questions, Answered

“Johanna Olson-Kennedy, Rachel Levine, or Marci Bowers have been subpoenaed before Congress to explain why the science is or isn’t actually settled re: children transitioning”— (Some Of) Your July 2025 Questions, Answered

“Dr. Kellan Baker, Executive Director of the Institute for Health Research and Policy at Whitman-Walker, said: “This report is pure politics masquerading as science. Rather than following the recommendations of every major US expert medical association, including the American Medical Association and the American Academy of Pediatrics, it pushes the dangerous and discredited practice of conversion therapy to try to force transgender people to change a fundamental, deeply rooted part of who they are.””— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“Consider instead an adolescent cis boy who experiences gynecomastia, unwanted but harmless growth of breast tissue. Under SB1, he may still receive testosterone therapy to reduce his breasts... But an adolescent trans boy may not, under SB1, receive the same treatment to achieve the same effect — reduction of breasts that are incongruent with his gender identity.”— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“In Justice Sotomayor’s dissent, she wrote that “This case presents an easy question: whether SB1’s ban on certain medications, applicable only if used in a manner ‘inconsistent with. . . sex,’ contains a sex classification.” She further describes the sex classification as “plain on the face of this statue,””— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

““Puberty blockers did not lead to mental health improvements, she said, most likely because the children were already doing well when the study began,” explained Ghorayshi, and Olson-Kennedy said she was worried this finding would be weaponized in the current political client.”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

““Our results provide a strong scientific basis that gender-affirming care is crucial for the psychological well-being of our patients,” said Garofalo in a press release published by the hospital.”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

““The Rafferty statement,” as it is commonly known, is larded with activist language, strange claims, and basic errors. ... “There is a limited but growing body of evidence that suggests that using an integrated affirmative model results in young people having fewer mental health concerns whether they ultimately identify as transgender. 24, 36, 37””— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping Implode Their Own Credibility (Part 1 of 2)

“AAP Statement on HHS Report Treatment for Pediatric Gender Dysphoria By: Susan J. Kressly, MD, FAAP, president, American Academy of Pediatrics “The American Academy of Pediatrics (AAP) is deeply alarmed by the report... This report misrepresents the current medical consensus...”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping Implode Their Own Credibility (Part 1 of 2)

“Johanna Olson-Kennedy, who is one of the most prominent proponents of youth gender medicine in the United States, as well as the medical director at the largest youth gender clinic in the country. She has long criticized comprehensive psychological assessments prior to medical transition as unnecessary “gatekeeping” — “I don’t send someone to a therapist when I’m going to start them on insulin,” she told me in 2018”— Read My Story About A Major Detransition Lawsuit In The Economist

“Hobbes vehemently disputed Cass’s account, and claimed Cass is expressing a transphobic — sorry, sorry, polite transphobic — viewpoint rather than a scientifically grounded one.”— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“Hilary Cass said in an interview with the editor of the British Medical Journal, “I can’t think of another area of pediatric care where we give young people a potentially irreversible treatment and have no idea what happens to them in adulthood.””— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“Yesterday CNN published an article by senior writer Tara John about the UK National Health Service’s newly skeptical stance... John writes that “Gender-affirming care is medically necessary, evidence-based care”— Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

“Pediatrics just published a “Perspectives” article on youth gender medicine (an opinion piece, more or less) by Emily Georges, Emily C.B. Brown, and Rachel Silliman Cohen that is one of the worst offenders I’ve come across.”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“most recently for holding medical articles to standards of rigor (you shouldn’t have had to, but the journals didn’t require accuracy or making sense, so thank you for pointing it out!).”— Your October Questions, Answered

““To be clear: What this pediatrician did was consistent with current medical advice. The consensus among clinical associations and experts — like the American Academy of Pediatrics, the American Medical Association and many, many others — is to evaluate and listen to a young person when they come out as trans. That’s because the evidence shows that trusting trans kids is the right thing to do.””— Why So Many People Told Me To Kill Myself This Weekend

“I remain opposed to these bills for reasons I’ve expressed consistently for years, but factually speaking, this is a terrible argument against them.”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“Julia Corcoran, the UI plastic surgeon and study coauthor listed on the consent forms, didn’t return a request for comment”— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“nor did Sumanas Jordan of Northwestern, the listed corresponding author.”— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

““[p]ersonally when someone claims to be the left of Bernie Sanders and tells an *outlandish* gender story that just happens to line up with right-wing agitprop, I know what to do: believe them,” commented Ryan Cooper, executive editor of the liberal American Prospect magazine.”— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

““[W]ow who could have predicted that the front-desk staffer who claimed children were given hormones for identifying as mushrooms and helicopters would have some credibility problems,” said the popular podcaster Michael Hobbes”— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

““Definitely building a stronger and stronger case that the helicopter lady is stable and reliable,” said Tom Scocca, a blogger and former Gawker Media staffer.”— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

““Dude. Dude. Let it go,” she tweeted at him. “You claimed kids were taking hormones to be helicopters. Take a beat. Exercise. Meditate. Ask hard questions with your therapist about why the personal lives of strangers bother you so much.””— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

“Rebecca Watson, who runs the science blog Skepchick, devoted a whole article and video to this made-up claim headlined “Journalist Thinks Trans Kids Are Getting Hormones to Turn into Helicopters.””— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

“Reed claims not to be very online, but when I first mentioned the helicopter kid on Monday night, it seemed like she had caught wind of some of the criticism and was exasperated by it. “I know exactly all about this!” she said. “This is driving me batty!””— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

“Kim Hutton, among those confused by the reports, views the treatment her son, now 19, received from Washington University’s Transgender Center at St. Louis Children’s Hospital as vital to making him the outgoing college freshman he is today. “The idea that nobody got information, that everybody was pushed toward treatment, is just not true. It’s devastating,” Hutton said. “I’m baffled by it.””— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

““I feel like I could go line by line to her affidavit,” Jones said, “and debunk it all.””— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

““I wrote the sentence Jesse is using and willfully misinterpreting to justify limiting access to care. It is about additional assessment to provide support for trans kids w mental health concerns. It is not about using mental health concerns to deny access to transition.””— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

““I am deeply disappointed and disgusted that my employer @nymag published this in response to the open letters to NYT,” wrote Madeline Leung Coleman, a New York mag editor. “Distorting, wrongheaded, shortsighted, un-fact-checked.””— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

“Alice Markham-Cantor, a fact-checker at the magazine, who wrote, “chait please i am begging. let us check your work before you post.””— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

““What our study found was just vast reductions in depression and suicidality, a reduction of depression of 60%, suicidality 73%. More to the point, we also saw worsening of these, as much as two- to three-fold and severity for the folks who did not receive similar care.””— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

“When I initially reached out to the lead author, Diana Tordoff, then a PhD student in the epidemiology department at UW, she said she and her team were sharing the data for transparency’s sake. When I pointed out that, in fact, the data was not available where it should be, she stopped responding.”— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

““The wild thing about this is that @emilybazelon is a great journalist on other topics,” he tweeted in response to Michael Hobbes (who we shan’t be discussing today), making sure to tag her. “Something about this just absolutely breaks people’s brains.””— I Would Like To Thank Not Only David Roberts, But All The David Robertses Out There

“Harriet has told me that you stated that her article “dragged SBM into a raging controversy.” She feels, and I agree, that it was your retracting that article and replacing it by very bad articles written by advocates of “gender affirmation” that dragged SBM into a raging controversy.”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“You claimed that Harriet’s article was below SBM’s minimal standard for "high quality scientific evidence and reasoning to inform medical issues." Yet you replaced it with articles stating things such as the following:”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“Harriet has told me that you stated that her article “dragged SBM into a raging controversy.””— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“Assistant Secretary for Health Dr. Rachel Levine strongly pressured WPATH leadership to rush the development and issuance of SOC-8, in order to assist with Administration political strategy.””— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

“Appendix A To Supplemental Expert Report Of James Cantor, Ph.D.”— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

““Scientists ourselves cannot agree on how to define the two sexes,” Rachel Levin, a Pomona College neuroscientist who studies the development of sex, told me over the phone. “To say that sex is simple and easily defined — and defined at conception — is factually incorrect.””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“There was a flurry of commentary this week suggesting that, by the Trump administration’s own definition, this could very well be the case. On Monday, you see, Trump kicked off his second term by signing a barrage of executive orders, including one stating that sex starts at the moment of conception — at which point, Trumpian science decrees, you are female or male and that’s it.”— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“The document represents “a dramatic failure to understand biology,” said Rachel Levin, a Pomona College neuroscientist who studies the development of sex.”— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“as she put it in an email she later posted to Twitter, “There are two reproductive categories, and Trump is correct that they are based on the kinds of gametes individuals are designed to produce.””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“Former president Donald Trump, author J.K. Rowling and billionaire Elon Musk were among those who referred to Khelif as a man or reposted such claims.”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

“Khelif’s own trainer also acknowledged an issue with her chromosomes and testosterone levels in an interview with a French publication.”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

““A level playing field is a fallacy,” says Dr. Myron Genel, Yale professor emeritus of pediatric endocrinology. He is a member of the International Olympic Committee's Medical Commission on issues regarding gender identity in athletics. “There's so many other factors that may provide a competitive advantage,” Genel says. “It's very hard to single out sex as the only one.””— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“I contacted Dr. Nicole LaVoi, director of the Tucker Center for Research on Girls & Women in Sport... “Both girls are on hormone suppression, which negates any competitive advantage due to testosterone... “My understanding is that after a year on hormone suppression the advantages of testosterone are mitigated,” she said.”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

““Medical scans and examinations—performed as a volunteer in medical studies—have since confirmed my predominantly female brai”— (Some Of) Your July 2025 Questions, Answered

“The article in question was a Perspective piece titled “The Future of Gender-Affirming Care — A Law and Policy Perspective on the Cass Review,” and it was written by the law professors Daniel G. Aaron of the University of Utah (also a physician) and Craig Konnoth of the University of Virginia.”— Two Unsurprising Updates On The Ongoing Self-Immolation Of Expert Authority

“Here’s the entire response I got from Aaron, verbatim but for some formatting changes... We agree and will request a correction.”— Two Unsurprising Updates On The Ongoing Self-Immolation Of Expert Authority

“as the holder of the 1st journalism professorship to focus on LGBTQ issues, much of Ben’s work—and this piece specifically—is dangerous to the wellness of LGBTQ people.”— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

“Her new thing is to express fury at some of her perceived enemies by publishing their phone numbers, albeit in a sleazy, plausibly deniable way: by posting photos of their emails containing that information.”— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

““I sent that email and other versions of it to over 200 doctors and press reps at medical institutions,” he said. “I asked people to send it to others and to email it to listservs. I knew very well that it would probably end up on Twitter and that Alejandra would post it. So I am fine with it being out there.””— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

““I think we need to correct what’s wrong first. And so that’s a big thing. I mean, particularly the medicalization of children.””— Former GLAAD President: We Were Wrong to Medicalize Trans-Identified Children

““This is finished business. It’s politicians and junk science, who’s creating some kind of debate or argument about this.” She went on: “It is not a debate. We are actually looking at the single source of truth and they are creating a conversation that doesn’t exist. It’s deeply rooted transphobia. That’s what it is, at the end of the day.””— Former GLAAD President: We Were Wrong to Medicalize Trans-Identified Children

Organizations Involved

The American Academy of Pediatrics issued its 2018 policy statement endorsing gender-affirming care and reaffirmed it in 2023, citing studies that later analyses showed lacked supporting outcome data on mental health improvements. The organization denounced the 2025 HHS report as misrepresenting consensus while continuing to guide pediatricians toward affirmation as standard practice. Its influence shaped clinical norms across the United States even as systematic reviews rated the underlying evidence as low certainty. ^[57][61]

World Professional Association for Transgender Health (WPATH) published Standards of Care versions that removed minimum age requirements for puberty blockers and hormones and allowed surgery without hormones in some cases, while internally acknowledging low-quality evidence. The organization faced accusations of political influence after internal documents revealed pressure from U.S. officials to excise age guidelines, and its commissioned reviews sometimes concluded likely benefits despite rating evidence as low. WPATH’s guidelines were cited widely by clinics and courts until growing scrutiny from European reviews challenged their rigor. ^[8][76][53]

Science-Based Medicine published a four-part series criticizing Abigail Shrier’s book and retracting an earlier favorable review by Harriet Hall, claiming strong evidence for youth gender medicine despite later corrections for factual errors including invented quotes and misrepresentations of researchers like Ray Blanchard and Kenneth Zucker. The site, dedicated to evidence-based evaluation, faced internal dissent from its emeritus editor Kimball Atwood over the handling of these articles. Its coverage reached influential skeptic audiences and helped sustain the assumption in certain professional circles. ^[34][35][74]

Yale Law School’s Integrity Project released a white paper critiquing the Cass Review for alleged methodological flaws and conflicts, authored by clinicians who themselves provided youth gender medicine and served as expert witnesses without disclosing those roles. The paper was promoted via press release, cited in media, and filed in litigation against state restrictions, yet subsequent analyses identified factual errors, misunderstandings of evidence-based medicine hierarchies, and selective quoting. Its institutional prestige lent weight to defenses of the assumption at a time when multiple countries were tightening access. ^[29][30][31]

▶ Supporting Quotes (116)

“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?

“health authorities in a number of countries have imposed restrictions. For example, the U.K. has banned the routine use of puberty blockers as an intervention for pediatric gender dysphoria.”— Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices

“These treatments—sometimes referred to as "gender-affirming care"—have been endorsed by several U.S. medical associations as safe and effective.”— Message Pediatric Gender Dysphoria Treatment

“The HHS Review identified serious methodological deficiencies in guidelines from the World Professional Association for Transgender Health (WPATH) and the Endocrine Society, including: Suppression of systematic evidence reviews; Inadequate management of conflicts of interest; Prioritization of non-clinical considerations over evidence; Failure to meet accepted standards for guideline trustworthiness and quality.”— Message Pediatric Gender Dysphoria Treatment

“No minor has satisfied eligibility criteria for cross-sex hormones under its updated National Health Service policies since the review's publication.”— Message Pediatric Gender Dysphoria Treatment

“Current clinical guidance for gender transition in adolescence follows the so-called ‘Dutch model’, formalised in WPATH standards of care”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“19 papers from 6 countries representing between 835 and 1354 participants were included in our final sample.”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“In August 2024, ASPS communicated to members that the Society had not endorsed any external organization’s clinical practice guidelines or recommendations for the treatment of children or adolescents with gender dysphoria.”— Position Statement on Gender Surgery for Children and Adolescents

“the 2025 report from the U.S. Department of Health and Human Services (HHS) titled Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices.”— Position Statement on Gender Surgery for Children and Adolescents

“Part 3 of this first-of-its-kind 3-part series helps show how pediatric primary care providers (PPCPs) are uniquely situated to screen, identify, and care for transgender and gender-diverse youths.”— Ethical Issues in Gender-Affirming Care for Youth

“Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York, New York”— Ethical Issues in Gender-Affirming Care for Youth

“The World Professional Association for Transgender Health (WPATH) publishes what is claimed to be the Standards of Care (SOC) for these interventions. WPATH promotes GAC, so the child or adolescent makes the diagnosis, not the healthcare professional.”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“GAC is now used by most clinics and upheld by major medical organizations (American College of Obstetricians and Gynecologists 2021; American Psychiatric Association 2018; Coleman et al. 2022; Hembree et al. 2017; Rafferty 2018).”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“the World Professional Association of Trangender Health’s transformation into a politically driven entity.”— Transsexualism is pseudoscience

“I thought this because I’m the sort of person who generally trusts what expert organizations, academics, professional journalists, and those in my social network (mostly, highly-educated progressives) say about things.”— How to Confront Highbrow Misinformation

“GR may be initiated during the developmental years with expectations of better bodily outcomes than when treatments are initiated in adulthood, and with positive psychosocial outcomes such as reduced depression, self-harm and suicidality.”— All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study

“published this week in the Archives of Sexual Behavior”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“Following a retraction by Springer, this research was re-published by the Journal of Open Inquiry of the Behavioral Sciences (JOIBS)”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“Contact with “gender specialists” was associated with social transition, and roughly doubled the rate of hormonal interventions”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“The idea that all people have an innate “gender identity” recently has been endorsed by many health-care professionals and mainstream medical organizations.”— No One Is Born in ‘The Wrong Body’

“Dr. Jonathan Howard, a neurologist and psychiatrist at NYU Langone Health, is furious at Michael Shermer”— How Can Doctors Like This Provide Competent Care To Their Patients?

“that’s why he wrote a deeply aggrieved article in Science-Based Medicine about Shermer’s bigotry.”— How Can Doctors Like This Provide Competent Care To Their Patients?

“The New England Journal of Medicine published an article titled “The Future of Gender-Affirming Care — A Law and Policy Perspective on the Cass Review,” ... Everything in it is still peer-reviewed.”— If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes

“The headline of the emailed version of the press release, for example, reads, “Gender-affirming care dramatically reduces depression for transgender teens, study finds.” The first sentence reads, “UW Medicine researchers recently found that gender-affirming care for transgender and nonbinary adolescents caused rates of depression to plummet.””— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“They simply followed the kids over time as some of them went on puberty blockers and/or hormones, administering self-report surveys tracking their mental health. There were four waves of data collection: when they first arrived at the clinic, three months later, six months later, and 12 months later.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“An article called “Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care” was published in JAMA Network Open late in February.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“Alas, this argument wasn’t printed on some random blog, but as a cover story in New York magazine, where I worked as an online editor and writer-at-large from 2014 to 2017. Chu is given almost 8,000 words to defend her radical argument”— Andrea Long Chu’s ‘New York’ Cover Story About Trans Kids Is, Above All Else, Lazy

“In the States, the few youth gender clinics mostly followed a version of the so-called Dutch Protocol, based out of a clinic founded in Utrecht and later moved to Amsterdam. The Dutch discouraged social transition, because their research showed that most kids with gender dysphoria would grow out of it in time”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“The TransYouth Project, as it came to be called, has since become the single largest and most successful longitudinal effort to track early transitioning youth in the U.S./the world.”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“Breen is a 20-year-old UCLA student who is suing Dr. Johanna Olson-Kennedy, medical director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles (CHLA). Breen detransitioned after receiving puberty blockers, hormones, and a double mastectomy while under Olson-Kennedy’s care.”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“she co-chairs a trans youth support group called Transforming Family with Olson-Kennedy and Dr. Aydin Olson-Kennedy”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“Yale Law School published a press release accompanying the white paper highlighting its level of rigor.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“published by The Integrity Project, a Yale Law School center... that Yale Law School then threw its weight behind it”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“The Review concurs with the WPATH Standards of Care and the Endocrine Society Clinical Practice Guidelines that: (1) medical care is appropriate for some transgender youth”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“a white paper titled “An Evidence-Based Critique of ‘The Cass Review’ on Gender-affirming Care for Adolescent Gender Dysphoria.” That paper, published by Yale Law School’s Integrity Project (and promoted by the law school itself)”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“a peer-reviewed response to McNamara et al. was recently published in Archives of Disease in Childhood, the journal that published the Cass Review’s systematic reviews.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“a scandal involving youth gender medicine at Karolinska University Hospital, which is considered one of the top hospitals in the world.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“neither of the two most important guidelines in this area, WPATH’s Standards of Care or the Endocrine Society’s practice guidelines, explicitly bar cross-sex hormones for those under 16. The former has almost nothing to say on the matter... the latter notes that “We recognize that there may be compelling reasons to initiate sex hormone treatment prior to age 16 years, although there is minimal published experience treating prior to 13.5 to 14 years of age.””— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“If you read the site’s recent coverage of this issue, you will come away thinking there is a big, broad, impressive body of evidence for youth gender medicine, that there isn’t any actual controversy here at all.”— How Science-Based Medicine Botched Its Coverage Of The Youth Gender Medicine Debate

“Science-Based Medicine has abandoned its commitment to rigorous science communication and has decided to wholeheartedly adopt the frequently false and oversimplified claims of activists”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“the positive results reported in “Psychosocial Functioning in Transgender Youth after 2 Years of Hormones,” a highly anticipated research paper just published in The New England Journal of Medicine”— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

“The TYCUS study is taking place at four major youth gender clinics: The Center for Transyouth Health and Development at Children’s Hospital Los Angeles; the Gender Multispecialty Service at Boston Children’s Hospital; the Child & Adolescent Gender Center Clinic at Benioff Children’s Hospital in San Francisco; and the Gender Identity & Sex Development Program at Lurie Children’s Hospital of Chicago.”— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

“The New England Journal of Medicine published a highly anticipated study called “Psychosocial Functioning in Transgender Youth after 2 Years of Hormones.””— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

“Science Vs, a leading science journalism podcast produced by Gimlet, is dedicated to cutting through misinformation and politicization and delivering its listeners the truth.”— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“All of the documents here are either irrelevant or contain plainly misleading citations.”— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“The book that psychiatrists use to treat their patients -- the DSM- it only stopped listing transgender as a mental disorder five years ago.”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“in May they announced that they were no longer initiating new hormone treatments for minors, unless it was part of a research project. And they didn't have any ongoing research projects. Meaning that, in reality, it was a stop.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“Zack Ford of ThinkProgress, for example, that publication’s leading authority on trans issues”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“Here’s BuzzFeed’s LGBT editor, Shannon Keating, in a tweet that helped spark what would become a bit of a Twitter pileon centered on Sohn’s piece”— Is The Process Of Science Reporting Inherently Transphobic?

““At the New York Times, ‘Objectivity’ Means Quoting One Trans Teen and One Anti-Trans Group.””— Is The Process Of Science Reporting Inherently Transphobic?

“the latter notes that “We recognize that there may be compelling reasons to initiate sex hormone treatment prior to age 16 years, although there is minimal published experience treating prior to 13.5 to 14 years of age.””— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“This Rolling Stone article by EJ Dickson is about the case of an unfortunate Texas child... I’m happy to opine on this paragraph from the Rolling Stone article, though:”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“Switching gears a bit, here’s a paragraph that jumped out at me from Jack Turban’s otherwise reasonable article about how conversion therapy is bad”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“Come On, Vox This one is a bit more in-depth. It’s from a piece by Katelyn Burns”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“Foreign Policy finally agreed with most of my suggestions and updated/corrected the article on February 2nd”— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

“As a result of the ruling, the Tavistock and Portman NHS Foundation Trust, which oversees youth GD treatment for the NHS, “immediately suspended such referrals for under-16s,””— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

“published in JAMA Pediatrics by a group of Northwestern University medical researchers”— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

“the headline of that comment — about a study that didn’t include any validated measures — is “Top Surgery in Adolescents and Young Adults—Effective and Medically Necessary.””— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

““They’re all *terrified*. They’re all *traumatized*.””— The Disaster At McMaster Part 2: My Interview With Gordon Guyatt

““They’re presenting a front as evidence-minded, yes.””— The Disaster At McMaster Part 2: My Interview With Gordon Guyatt

“five scholars from the Department of Health Research Methods, Evidence, and Impact (HEI) at McMaster University published a statement criticizing the Society for Evidence-Based Gender Medicine (SEGM)”— The Disaster At McMaster, Part 1

“This campaign culminated in the Southern Poverty Law Center’s decision to label SEGM a “hate group” in 2024.”— The Disaster At McMaster, Part 1

“My critiques of the American Academy of Pediatrics (AAP) and Kellan Baker bring me to an article in Science by general assignment reporter Phie Jacobs headlined “Researchers slam HHS report on gender-affirming care for youth.””— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“Rather than following the recommendations of every major US expert medical association, including the American Medical Association and the American Academy of Pediatrics”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“Mark Joseph Stern of Slate, whose response to Skrmetti was headlined “John Roberts’ Anti-Trans Opinion Is a Garbled Mess. It’s Easy to See Why.””— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“Launched in 2015, this is the most ambitious American attempt to gather data on minors who are medically transitioning. While the $10 million or so given to this team by the National Institutes of Health...”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

“The Olson-Kennedy team’s most important paper to date, “Psychosocial Functioning in Transgender Youth after 2 Years of Hormones,” was published in The New England Journal of Medicine in 2023...”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

“In 2018, the AAP published a “policy statement” lead-authored by the psychiatrist and youth gender clinician Jason Rafferty that suffers from basically every flaw the organization attributes to the HHS report, and which is still considered to be the AAP’s active guidance on the subject of youth gender medicine.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping Implode Their Own Credibility (Part 1 of 2)

“the practices of the United States’ largest youth gender clinic... Image: Children’s Hospital of Los Angeles, via CHLA.org.”— Read My Story About A Major Detransition Lawsuit In The Economist

“WPATH Standards of Care: “Despite the slowly growing body of evidence supporting the effectiveness of early medical intervention, the number of studies is still low, and there are few outcome studies that follow youth into adulthood. Therefore, a systematic review regarding outcomes of treatment in adolescents is not possible.””— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“this exact sentence, and close variants of it, has been copied and pasted into dozens of CNN.com stories over the last few years”— Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

“The fact that Pediatrics would publish this article in its current form — and I’m getting déjà vu typing these sorts of sentences over and over and over — is a really bad sign about the collapse of institutional credibility in this area.”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“The second citation points to Jason Rafferty’s policy statement for the American Academy of Pediatrics, which is a very strange document that certainly does not provide evidence that youth gender medicine has been “shown to decrease” depression and anxiety.”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“But the SoC also notes that “Despite the slowly growing body of evidence supporting the effectiveness of early medical intervention, the number of studies is still low, and there are few outcome studies that follow youth into adulthood. Therefore, a systematic review regarding outcomes of treatment in adolescents is not possible.””— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

““the consensus among clinical associations and experts — like the American Academy of Pediatrics, the American Medical Association and many, many others — is to evaluate and listen to a young person when they come out as trans.””— Why So Many People Told Me To Kill Myself This Weekend

“Earlier this week the American Medical Association announced that its House of Delegates had “passed the Endocrine Society’s resolution to protect access to evidence-based gender-affirming care for transgender and gender-diverse individuals.””— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“More than 2,000 scientific studies have examined aspects of gender-affirming care since 1975, including more than 260 studies cited in the Endocrine Society’s Clinical Practice Guideline.”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“the most influential organization... the World Professional Association for Transgender Health, removed all age guidelines from its Standards of Care shortly after it was published.”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“Here’s the article. I feel a little bad critiquing it because it was written by a SciAm intern. But it was published in one of the leading science outlets in the world, and it does have some major problems”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“if WPATH thought there was good, high-quality evidence to support blockers, of course it would have shined a spotlight on it.”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“a JAMA Pediatrics study following up with a group of young people aged 13 to 24 three months after they got double mastectomies to treat their gender dysphoria.”— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“The University of Illinois sent me only a fraction of what I was asking for. The research protocol and other material couldn’t be sent over, they said, because it’s exempt from FOIA requests “under the Illinois Medical Studies Act.””— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“The “baffled” line was compelling enough that it was integrated into the article’s headline. But Colleen Schrappen, the article’s author, doesn’t note that Kim Hutton is the cofounder of TransParent, a group that advocates for trans kids and their access to medical treatment.”— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

“The picture painted by whistleblower Jamie Reed of how patients were treated at the Washington University Transgender Center at St. Louis Children’s Hospital doesn’t match Jess Jones’ experience.”— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

““Adolescents assigned female at birth initiate transgender care 2.5 to 7.1 times more frequently than those assigned male at birth,” according to WPATH.”— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

“Some of Chait’s colleagues were furious. “I am deeply disappointed and disgusted that my employer @nymag published this in response to the open letters to NYT,””— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

“These emails really highlight the degree to which the comms staff didn’t care whether and to what extent false information about youth suicide was spread by their institution — all they cared about was that most of the media coverage had been positive.”— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

“The study took place at Seattle Children’s Hospital, two of the authors are based there... and it “was supported [by] Seattle Children’s Center for Diversity and Health Equity... Seattle Children’s Hospital has a gender clinic.”— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

“This controversy has led to heated debate within the World Professional Association for Transgender Health, or WPATH, as it has worked to complete the eighth edition of its Standards of Care, which will be out soon.”— I Would Like To Thank Not Only David Roberts, But All The David Robertses Out There

“Karolinska University Hospital, which is considered one of the top hospitals in the world.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“No, it was not Harriet who dragged SBM into a raging controversy. It was you and David, because of some very poor choices, made worse by your doubling down after every reasonable objection by Jesse Singal, Andy Lewis, Michael Shermer, Jerry Coyne, Abigail Shrier, me, and several others.”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“What GLAAD and the ACLU Did This Week Is Disturbing, But Unsurprising (Update)”— What GLAAD and the ACLU Did This Week Is Disturbing, But Unsurprising (Update)

“The response to 60 Minutes' segment on detransitioners is as predictable as it is depressing”— What GLAAD and the ACLU Did This Week Is Disturbing, But Unsurprising (Update)

“Consensus on the final recommendations was attained using the Delphi process that included all members of the guidelines committee and required that recommendation statements were approved by at least 75% of members.””— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

“I have just spoken to Admiral Levine today, who—as always is extremelysupportive of the SOC 8, but also very eager for its release—so to ensureintegration in the US health policies of the Biden government.”— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

“the American Academy of Pediatrics “issued an ultimatum to WPATH: Should WPATH not delete the age minimums, AAP would not only withhold endorsement of SOC-8, but would publicly oppose the document.””— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

“The headline of Arwa Mahdawi’s latest column in The Guardian reads, “After his executive order on sex, is Trump legally the first female president?””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“STAT News is supposedly a top-tier health news site. And STAT ran a similarly oriented article by Megan Molteni headlined “Trump executive order declaring only ‘two sexes’ gets the biology wrong, scientists say.””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“The likes of Nature, possibly one of the most prestigious scientific journals in the world, has noted that “the research and medical community now sees sex as more complex than male and female.””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“The Paris prosecutor’s office confirmed in an email Wednesday that it received the case that Khelif filed with its special unit for combating online hate speech. ... This comes after a flurry of online attacks spreading false claims about her gender.”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

“the IOC’s lack of any sort of substantive response — instead the IOC has fought back with a mix of high moral dudgeon”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

“Let’s start with a long feature in Bleacher Report about Andraya Yearwood, a trans teenager running track in Connecticut who (after this article was published) finished second in the 55-meter sprint at the Connecticut women’s indoor track and field championships”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“An article in The Nation about Yearwood and the broader trans-athletes debate takes things further... I contacted Dr. Nicole LaVoi... “Unfortunately, the backlash surrounding both athletes is in part due to lack of education and factual knowledge about transgender individuals.”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“In a blog post on these issues published on the ACLU’s website last month, a fellow and a staff attorney there write the following, taking this argument yet further: There is a long legacy of sex discrimination in athletics. Myths, such as the i”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“Science Vs claims that... “The only study we’ve found that zoomed in on kids [who identified strongly as being trans fairly early in life]… found that out of 45 of them… 44 grew up to be transgender.””— How 'Science Vs' Made Two Gender-Dysphoria Errors

“If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes... We have our answer!”— Two Unsurprising Updates On The Ongoing Self-Immolation Of Expert Authority

“the article had actually already been canceled by the Times because, he told me in an email, “the higher ups heard about it and told my editor they didn’t want a freelancer writing a story that sensitive.””— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

“he is the “inaugural Daniel H. Renberg Chair of social justice in reporting” at Northwestern University’s highly ranked Medill School of Journalism.”— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

“Graddick was also instrumental in GLAAD’s awareness and media competency campaigns around issues impacting the transgender community. GLAAD worked closely with the Colorado family of a transgender 6-year-old whose school refused to allow her to use the girl’s bathroom, filing a complaint with the state civil rights commission and elevating awareness about the situation.”— Former GLAAD President: We Were Wrong to Medicalize Trans-Identified Children

The Foundation

The assumption held that gender-affirming medical interventions for children with gender dysphoria satisfied basic standards of medical ethics on risk versus benefit. Supporters cited short-term studies suggesting reduced depression and suicidality, the reversibility of puberty blockers, and the idea that withholding care constituted harm given high baseline mental health risks in dysphoric youth. These claims seemed persuasive to many clinicians because they aligned with patient-reported relief and the broader cultural shift toward self-identified gender. ^[3][15]

A key sub-belief was that puberty blockers are reversible, buy time for decision-making, and improve mental health outcomes. Systematic reviews, however, found very low certainty evidence for these benefits, with 87 to 98 percent of blocker users proceeding to cross-sex hormones and documented declines in bone density. The 2025 HHS report and European reviews concluded that the evidence could not support firm determinations of effectiveness or safety. ^[5][8][20]

Another foundation was the claim that gender dysphoria in adolescents is stable and innate, justifying early medicalization to prevent suicide. Studies of desistance in earlier cohorts showed 60 to 85 percent of prepubertal cases resolving without intervention, often into same-sex attraction, while adolescent-onset cases surged with high psychiatric comorbidity. The Cass Review and Finnish register data highlighted that mental health treatment, not affirmation alone, correlated with reduced risk, and completed suicide rates remained elevated post-transition. ^[16][13][14]

Proponents also relied on the idea that social and medical transition alleviate chest and genital dysphoria without significant regret. The 2018 JAMA Pediatrics study on mastectomy used an unvalidated Chest Dysphoria Measure showing score reductions but omitted planned gender dysphoria data collected via the Utrecht scale. Long-term regret data came mostly from adult cohorts with high loss to follow-up, while youth-specific evidence remained limited and contested. ^[48][59]

▶ Supporting Quotes (127)

“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?

“the use of pharmacological and surgical interventions as treatments for pediatric gender dysphoria has been called “medically necessary” and even “lifesaving.” ... the diagnosis of gender dysphoria is based entirely on subjective self-reports and behavioral observations, without any objective physical, imaging, or laboratory markers. ... the natural history of pediatric gender dysphoria is poorly understood, though existing research suggests it will remit without intervention in most cases.”— Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices

“Evidence Quality: The overall quality of evidence concerning the effects of puberty blockers, cross-sex hormones, and surgeries on psychological outcomes, quality of life, or long-term health in minors is very low.”— Message Pediatric Gender Dysphoria Treatment

“Therapeutic Benefits: Available evidence cannot support determinations regarding the effectiveness of these medical interventions for improving mental health or alleviating gender dysphoria symptoms in children and adolescents.”— Message Pediatric Gender Dysphoria Treatment

“The first stage, puberty suppression (PS; prevention of the development of secondary sexual characteristics), is reversible (although not without risks to health and wellbeing)”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“There is some indication in the literature that adolescents are unlikely to desist”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“ASPS recognized that the evidence base informing medical and surgical interventions in this population was limited and characterized as low quality/low certainty (i.e., there was limited confidence that the intervention’s reported effects reflected the true effects).”— Position Statement on Gender Surgery for Children and Adolescents

“The concept of “patient values and preferences” has been cited as sufficient rationale for the treatment of children and adolescents in the face of very low/low certainty evidence; however, high-quality research on patient values and preferences is missing in this area of medicine.”— Position Statement on Gender Surgery for Children and Adolescents

“Available evidence suggests that a substantial proportion of children with prepubertal onset gender dysphoria experience resolution or significant reduction of distress by the time they reach adulthood, absent medical or surgical intervention.”— Position Statement on Gender Surgery for Children and Adolescents

“Transgender and gender-nonconforming (TGNC) youth who suffer from gender dysphoria are at a substantially elevated risk of numerous adverse physical and psychosocial outcomes compared with their cisgender peers. Innovative treatment options used to support and affirm an individual’s preferred gender identity can help resolve gender dysphoria and avoid many negative sequelae of nontreatment. Yet, despite advances in these relatively novel treatment options, which appear to be highly effective in addressing gender dysphoria and mitigating associated adverse outcomes [...] little is known about the long-term effects of both hormonal and surgical interventions in this population.”— Ethical Issues in Gender-Affirming Care for Youth

“Ethical considerations in gender-affirming care for TGNC youth span concerns about meeting the obligations to maximize treatment benefit to patients (beneficence), minimizing harm (nonmaleficence), supporting autonomy for pediatric patients during a time of rapid development, and addressing justice, including equitable access to care for TGNC youth.”— Ethical Issues in Gender-Affirming Care for Youth

“PBs are often presented as reversible and as a means to allow a young person to have more time to decide (Carmichael et al. 2021; Delemarre-van de Waal and Cohen Kettenis 2006), yet the overwhelming majority of those who go on PBs (87–98%) proceed to CSHs”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“The current diagnosis is completely reliant on self-report. ... Instead of exploring underlying issues (which are common in young people with gender distress), such as mental health, sexual abuse, history of bullying, and history of trauma, the healthcare professional is obligated to affirm the patient's chosen identity.”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“an exposé of the World Professional Association of Trangender Health’s transformation into a politically driven entity.”— Transsexualism is pseudoscience

“Gender Dysphoria 93 Gender and Physiology 98 Transgender Identity in Children 105 Therapeutic Interventions in Children 106 Therapeutic Interventions in Adults 108”— Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences

“Respondents oppose teaching children that “There is no such thing as biological sex, only gender preference” by 85 to 15;”— THE POLITICS OF THE CULTURE WARS IN CONTEMPORARY CANADA

“For several years, I assumed that there was a lot of high-quality medical evidence supporting the efficacy and safety of youth gender medicine (i.e., treatments like “puberty blockers” and hormone therapy for young teens), as well as evidence suggesting that those who don’t get specific treatments are at high risk for suicide.”— How to Confront Highbrow Misinformation

“GR may be initiated during the developmental years with expectations of better bodily outcomes than when treatments are initiated in adulthood, and with positive psychosocial outcomes such as reduced depression, self-harm and suicidality; however, the evidence base for these psychosocial benefits is weak.”— All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study

“Psychiatric morbidity is common in gender-referred adolescents. Despite the lack of studies on psychiatric morbidity in the context of GD, it remains that psychiatric morbidity is a well-established predictor of suicide, a major confounding factor, and 20–80% of young people seeking gender identity services present with psychiatric morbidities.”— All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study

“A specific claim is that there was one suicide by a patient on the GIDS waiting list in the 3 years before the High Court judgment, and 16 deaths (rather than suicides) in the 3 years after the judgment.”— Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report

“However, the evidence for “gender-affirming care” in the form of puberty-blocking drugs is unreliable. In contrast, a robust study from Finland published earlier this year (Ruuska et al, BMJ Mental Health 2024) reported that suicide risk was reduced after gender reassignment but that the improvement was explained by the treatment of co-existing mental ill-health.”— Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report

““Due to the important limitations in the body of evidence, there is great uncertainty about the effects of puberty blockers, cross-sex hormones, and surgeries in young people with gender dysphoria.””— AHCA: About AHCA

““The affirmation advocates repeatedly refer to the established increased risk of suicide if any of the affirmation strategies are not followed to completion. They point to their own published studies touting dramatic improvement in mental health status of patients who are affirmed in all three ways, but they cite data from convenience sampling, which never should be used to prove anything other than association, at best. Such studies can never prove causation.””— AHCA: About AHCA

“Opponents of the ROGD hypothesis claim that the surge is merely the result of greater acceptance of transgender identities by society, and hence, a greater willingness among “intrinsically transgender” adolescents to “come out.””— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“It also has become common to claim that this sense of identity may be reliably articulated by children as young as three years old. Developmental studies show that young children have only a superficial understanding of sex and gender (at best).”— No One Is Born in ‘The Wrong Body’

“To such extent as any such identity may exist, the concept relies on stereotypes that encourage the conflation of gender with sex.”— No One Is Born in ‘The Wrong Body’

“In addition to the fact that the researchers simply didn’t report the results of a number of the key variables in their preregistration’s primary hypothesis — likely indicating they didn’t get the results they wanted — the seeming “improvements” they did report were of questionable size, mostly applied to female-to-male but not male-to-female participants”— How Can Doctors Like This Provide Competent Care To Their Patients?

“There was a popular claim that if you identified as trans as an adolescent that it would be stable, originally made for these prepubertal kids but then extended to those with later onset.”— Your December Questions, Answered (1 of 2)

“A kid who is experiencing some degree of turmoil and rapidly cycling through identities is likely to... continue cycling through identities.”— Your December Questions, Answered (1 of 2)

“It’s exceptionally unfortunate that so many activists and actual, real-life doctors have spread the meme that kids will kill themselves if they don’t get treatment.”— Your December Questions, Answered (1 of 2)

“The [Cass] Review calls for evidentiary standards for GAC [gender-affirming care] that are not applied elsewhere in pediatric medicine. Embracing RCTs [randomized-controlled trials] as the standard, it finds only 2 of 51 puberty-blocker and 1 of 53 hormone studies to be high-quality.”— If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes

“A good number of those falsehoods, distortions, and misunderstandings seem to have come from the Yale “Integrity Report” white paper lead-authored by Meredithe McNamara, which is Aaron and Konnoth’s first citation.”— If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes

““After adjustment for temporal trends and potential confounders, we observed 60% lower odds of depression (adjusted odds ratio [aOR], 0.40; 95% CI, 0.17-0.95) and 73% lower odds of suicidality (aOR, 0.27; 95% CI, 0.11-0.65) among youths who had initiated PBs or GAHs compared with youths who had not.””— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“The “Key Points” box found to the right of the abstract reads, “In this prospective cohort of 104 TNB [transgender and nonbinary] youths aged 13 to 20 years, receipt of gender-affirming care, including puberty blockers and gender-affirming hormones, was associated with 60% lower odds of moderate or severe depression and 73% lower odds of suicidality over a 12-month follow-up.””— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“it took what was threatening to become a social issue, hence a question of rights, and turned it back into a medical issue, hence a question of evidence; it then quietly suggested that since the evidence was debatable, so were the rights.”— Andrea Long Chu’s ‘New York’ Cover Story About Trans Kids Is, Above All Else, Lazy

“Dr. Olson has previously argued that in the aughts and 2010s, Zucker and his colleagues’ high desistance statistics stemmed from a misunderstanding: The kids at their clinics were mostly gender nonconforming, rather than having severe gender dysphoria or outright endorsing a trans identity.”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“They express skepticism of this idea on the grounds that most of the siblings of trans youth “are cisgender.” “Presumably, if parents were encouraging gender nonconformity, in general, we might see a higher rate of transgender identity among the siblings.””— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“This material is littered with, if not red flags, at least yellow ones — signs that Clementine’s questions about her gender identity had come about only recently, and that there was also some recent trauma in her family that might be worth exploring.”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“McNamara and her colleagues accuse the process behind the publication of the Cass Review of lacking transparency, writing that “many of the Review’s authors’ identities are unknown. Transparency and trustworthiness go hand-in-hand, but many of the Review’s authors cannot be vetted for ideological and intellectual conflicts of interest.””— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“The authors write early on: ... 'Unfortunately, the Review repeatedly misuses data and violates its own evidentiary standards by resting many conclusions on speculation. Many of its statements and the conduct of the York SRs reveal profound misunderstandings of the evidence base and the clinical issues at hand.'”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“a single, very carefully conducted randomized controlled trial can tell you more about a treatment’s efficacy than a pile of weaker studies.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“Children and young people can experience this as a ‘clinician lottery,’ and failure to have an open discussion about this issue is impeding the development of clear guidelines about their care.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“Without evidence, the Review states that “practitioners abandoned normal clinical approaches to holistic assessment” (p 13) and that puberty-pausing medications are “available in routine clinical practice.” (p 25) However, the Review’s own data shows that about only 178 youth with gender dysphoria in the UK currently receive medications that pause puberty.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“First, it reports over two years of waiting for assessment. (p 77) Then, of the 3306 patients seen twice in the GIDS [Gender Identity Development Service] clinic or discharged from April 2018-December 2022, only 27% (892) were referred to endocrinology for consideration and consultation of medical interventions.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“The Review claims that these interventions may “change the trajectory of psychosexual and gender identity development.” (p 83) There is no description of how developmental trajectories might be impacted, nor are any data cited.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“Studies in the 1980s demonstrated that most gender non-conforming children would not meet criteria for gender dysphoria after progression through puberty. These studies inappropriately conflated concepts of gender identity, sexual orientation, and behavior inappropriately.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“Baked into the general medical consensus that puberty blockers are safe and reversible is the assumption that they’re not going to be used for too long a period.”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“We have far less data about physical transition for youth, when it comes to both puberty blockers and hormones, than we do for adults. And there are myriad unknowns and tradeoffs that don’t apply, or at least not as much, to the adult setting.”— How Science-Based Medicine Botched Its Coverage Of The Youth Gender Medicine Debate

“Where citations are provided for claims – a rare phenomenon in this book!”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“Modern attempts to characterize the population into a simple sex ratio results in an overall estimate of 1:1, as is seen in the US Trans Survey, a population-based survey”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“One meta-analysis of transgender adults found, at most, a 1% regret rate amongst those who had undergone surgery”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“The oft-cited “80% of children will change their mind” statistic comes largely from four observational studies from 2008 to 2013 in Canadian clinics.”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“they simply excluded most of the key variables they had hypothesized would improve as a result of hormones, and that they changed their hypothesis significantly”— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

“Appearance congruence: Increase of 0.96 out of 5 points Positive affect: Increase of 1.6 out of 100 points Life satisfaction: Increase of 4.64 out of 100 points Depression: Decrease of 2.54 out of 63 points Anxiety: Decrease of 2.92 out of 100 points”— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

“in my last post, I pointed out something arguably suspicious about the study: In their study protocol, including a version that they submitted into a preregistration database, the researchers hypothesized that members of this cohort would experience improvement on eight measures, including ones that are just about universally recognized by youth gender researchers as important outcomes, such as gender dysphoria, suicidality, and self-harm.”— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

“those who got gender affirming care were 73% less likely to have thoughts of killing themselves or hurting themselves.”— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“Being trans was not considered a mental disorder in the DSM-IV, nor is it one in the DSM-5. Rather, both editions sought to diagnose people who suffer from gender dysphoria, or a deep sense of discomfort with one’s biological sex* or its associated gender.”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“transgender healthcare was somehow only affirming the people who were seeking healthcare at the clinics. They didn't ask the more problematic questions, like, Could this feeling you have of not being the gender you were born to be come from something else but gender dysphoria?”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“the way they had been treating these very few patients was the way they were treating everyone now coming in. And that is an experimental treatment, because there's not enough scientific basis for it.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“Skeptics of these criteria harp on criterion A a great deal, particularly the fact that A(1) — a “repeatedly stated desire to be, or insistence that he or she is, the other sex” — isn’t required for a kid to qualify as having gender identity dysphoria.”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“the studies purporting to show high desistance rates were really tracking large numbers of kids who weren’t gender dysphoric to begin with — rather, those kids were merely gender nonconforming”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“Salem felt driven to feminize their body, to lessen their constant alienation from their own anatomy — and their self-revulsion — but wasn’t at all sure what the right combination of feminine and masculine would be. Different days brought different answers. From the hormones, their breasts were buds.”— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“the goal of treatment [for nonbinary people] is often unclear to the patient themself; the prevailing binary paradigm doesn’t apply... Even so, Tate commented tentatively that Salem seemed more confident since starting the hormones, that Salem seemed to be making progress in accepting themself. “While I’m presenting myself as more comfortable,” Salem mumbled, head bowed, “the feeling I have is that I hate myself.””— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“It’s Keating’s claim that 4thWaveNow is an “anti-trans hate group” that really gives away the game here.”— Is The Process Of Science Reporting Inherently Transphobic?

“The result is fear-mongering article that further damages a group that faces alarming rates of suicide and violence, another essential factoid left out of the piece.”— Is The Process Of Science Reporting Inherently Transphobic?

“Steensma estimated to me that about 60% of the young people who pass through his clinic and who meet the clinical criteria for GD at one point eventually desist.”— Is The Process Of Science Reporting Inherently Transphobic?

““Far and away most importantly,” said Metzger, “there is the fact that these kids are suffering by not having the bodies they need to match their gender. This is a high-risk group in terms of emotional problems, self-harm, suicidal thoughts, etc, etc. At some point you have to look at the risk-benefit of treating kids at age X or maturity level Y, and the risk of not moving ahead with hormones is too great.””— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“The Endocrine Society’s clinical guidelines, meanwhile, say this (emphasis mine): Clinicians may add gender-affirming hormones after a multidisciplinary team has confirmed the persistence of gender dysphoria/gender incongruence and sufficient mental capacity to give informed consent to this partially irreversible treatment. Most adolescents have this capacity by age 16 years old. We recognize that there may be compelling reasons to initiate sex hormone treatment prior to age 16 years”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“Ever since the DSM-5 was published in 2013, a bunch of people have falsely spread the rumor that “being transgender,” or “exhibiting gender diversity,” or some other, similar thing, switched from being a mental disorder in IV to not being a mental disorder in 5.”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“Burns seems to be simply confused about what the “watchful waiting” approach is. In fact, the phrase “developed by Dutch and Canadian clinicians” suggests she’s lumping together two different approaches”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“This case is a judicial review of the GIDS policy, not a tort action relating to the specific facts surrounding the first claimant’s treatment and it is not necessary therefore to resolve any factual dispute.”— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

“This ruling does not cover "Britain", because this was a judgement against NHS England and applies only to England.”— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

““The IPTW model estimated a 25.58 (95% CI, –29.18 to –21.98) point decrease in CDM for the surgery group relative to the control group.””— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

“That paper also looked at the outcomes of a cohort of young people who got double mastectomies — between the ages of 13 and 25, in this case... “no data documenting the effect of chest surgery on minors.””— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

““What bullshit is that, frankly? If you take that position, we wouldn’t be able to have conversations about two-thirds of our medical therapies.””— The Disaster At McMaster Part 2: My Interview With Gordon Guyatt

“the assessments of the certainty of evidence using established and standard methodology are interpreted as evidence supporting denial of care... when the certainty of the evidence is low or very low. In such circumstances, clinicians should work with patients to ensure that care reflects the experience, goals, and priorities”— The Disaster At McMaster, Part 1

“a lot of the most prominent proponents of youth gender medicine make misleading arguments, hide or refuse to publish data, engage in prima facie reckless practices toward vulnerable youth”— (Some Of) Your July 2025 Questions, Answered

“Despite the limitations of the available evidence, however, our review indicates that gender-affirming hormone therapy is likely associated with improvements in QOL, depression, and anxiety. No studies showed that hormone therapy harms mental health or quality of life among transgender people.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“By contrast, the most recent standards for the treatment of gender dysphoria in youth issued by the World Professional Association for Transgender Health (WPATH)—an organization that determines the clinical protocols used by the majority of professionals who work with trans people—took more than a decade to compile with numerous systematic reviews, and “reflect the consensus of hundreds of experts in transgender health from around the world,” Baker says.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“according to experts, “In the majority of cases of pubertal gynecomastia, observation and reassurance are the mainstays of therapy as the condition usually resolves naturally. Pharmacological treatment and surgery are recommended only in selected cases.””— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“For instance, in Morales-Santana, the law at issue classified on the basis of a parent’s physical presence in the United States. That, all agree, was permissible. But the law also classified on the basis of the parent’s sex. And that, the court held, created a “gender line” that triggered heightened scrutiny.”— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“We have the exact same problem in this preprint as we did in the NEJM paper: The researchers changed from looking at one set of variables to another without offering any explanation why.”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

“To make even this modest claim about the evidence base for “an integrated affirmative model,” Rafferty and his team are forced to reach for citations that are simply inapplicable. Footnote 24 points to this 2012 paper... On top of that, this paper presents no outcome data... Footnote 36 points to this study... this paper obviously does not promote the affirmative model... Footnote 37 points to another paper... the authors themselves don’t think this study proves much of anything.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping Implode Their Own Credibility (Part 1 of 2)

““I don’t send someone to a therapist when I’m going to start them on insulin,””— Read My Story About A Major Detransition Lawsuit In The Economist

“the USTS only includes individuals who currently identify as trans, and who chose to participate in a survey about being trans. To say that this limits the conclusions we can draw from the results is a wild understatement.”— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“The studies we have offer mixed results, suffer from suspiciously missing data, are misconstrued by their own authors, and have other backbreaking problems.”— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“whether youth gender medicine is medically necessary and evidence-based is exactly the thing being debated... every national health system that has examined this question closely... has come to the same conclusion: the evidence is paltry”— Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

“"used in pediatrics since the 1980s” is exceptionally misleading, because the context there was (generally) precocious puberty, meaning that after the kids ceased blockers their natal puberty (presumably) kicked in, whereas research shows that the vast majority of kids who go on puberty blockers to treat gender dysphoria subsequently proceed to cross-sex hormones.”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“It points to this study out of the Netherlands, which indeed showed a high continuation rate. But under that protocol — and this is very well-known to anyone who studies this issue — youth seeking blockers or hormones could be excluded for a wide variety of reasons, including mental health comorbidities, insufficiently severe symptoms, unsupportive parents, and so on.”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“There isn’t differential diagnosis to determine treatment recommendations (people don’t know how to determine for whom medical intervention might help, although there are some red flags to indicate whom it might hurt.…e.g., comorbidities, trauma, being gay, social pressures noted)”— Your October Questions, Answered

“someone considering medical treatment can’t be told the likelihood of any outcome or even how many have had bad outcomes or good outcomes. Or what will happen, most likely, if they don’t have this treatment, but do an alternative or no treatment ("BRAN"-benefits, risks, assessments and doing nothing).”— Your October Questions, Answered

“the Dutch protocol always refused some people, what treatment did they get?”— Your October Questions, Answered

““the evidence shows that trusting trans kids is the right thing to do. But Jeanne rejected that.””— Why So Many People Told Me To Kill Myself This Weekend

“those who follow this issue closely know that there is a major difference between studies of adult versus youth gender medicine. That’s because there are obvious and important distinctions between giving hormones to a not-fully-developed adolescent and to an adult”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“there is no reality-based sense in which affirming care is “designed to take a conservative approach.” In fact, the affirming approach grew out of a competing and more conservative approach: watchful waiting”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“Youth gender medicine interventions are not “reserved for older adolescents and adults.” Everyone knows this. It’s an absolutely baffling claim”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“Cross “Jack Turban study” off your bingo card. I am not going to debunk this study for the nth time. Click here and search down to “It is, to phrase things bluntly, not serious research””— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“Hormonal medications called gonadotropin-releasing hormone agonists (GnRHas), often referred to as puberty blockers, temporarily halt the production of sex hormones testosterone, estrogen and progesterone with minimal side effects.”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“They can pause puberty and buy transgender children and their caregivers time to consider their options.”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

““Despite the slowly growing body of evidence supporting the effectiveness of early medical intervention, the number of studies is still low, and there are few outcome studies that follow youth into adulthood. Therefore, a systematic review regarding outcomes of treatment in adolescents is not possible.””— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“The UGDS is an established, validated scale that has been in use for quite some time... Guess where the Utrecht GD Scale data is in the published paper? Nowhere, that’s where.”— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“To paraphrase the researchers: In the run-up to the study: “We’re interested in measuring gender congruence, gender dysphoria, chest dysphoria, and body image.” Describing the study after it was published: “We were interested in measuring gender congruence, chest dysphoria, and body image.””— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“The patient was quoted in the letter as saying they identified as a “communist, attack helicopter, human, female, maybe non binary.” The therapist also wrote that the patient reported that they “hope for the transition to feel better in my body and no longer just in a flesh box.””— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

“That, alone, is poor reporting: as a journalist, of course you should disclose relevant activist ties on the part of any source you quote.”— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

““[Mental health diagnoses] & access to [hormone replacement therapy] are not contraindicated. This sentence is to ensure that ppl get access to resources if they need them, not to determine if their MH concern is a ‘differential diagnosis’.””— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

“80% of the kids who didn’t go on GAM had dropped out of the study by the final wave of data collection, leaving just six remaining. That is far too small a sample to draw any conclusions from.”— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

““She does what you do, a bunch of ‘raising questions’ that already have answers, talking to ideologues as though they’re just people off the street, exclusively centering parents hostile to transition, & citing not one single solitary case of a transition being ‘too fast.’"”— I Would Like To Thank Not Only David Roberts, But All The David Robertses Out There

““Biology is a binary and differences of sex development (DSDs) are vanishingly rare”. False. DSDs are as common as 1 in 5,000 births, and increase to 1 in 200 or 1 in 300 if you include hypospadias and cryptorchidism. Biology is very, very well known to be a spectrum.”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“The “abundant” link is not to several studies or a review of several studies, as the adjective implies, but to a single study that is irrelevant to Shrier’s thesis because it looks at a group of pre-pubescent, transgender children (age 3-12) undergoing only social transition”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“Throughout her book, Shrier refers to her subjects as “biological girls,” a term that conflates sex with gender and mischaracterizes Shrier’s subjects. The reason is that a person’s sex refers to the identity assigned by doctors, parents, and medical professionals at birth”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“it focused mostly on detransitioners and the debate over the quality of care you…”— What GLAAD and the ACLU Did This Week Is Disturbing, But Unsurprising (Update)

“I don’t see how we can simply remove something that important from the document—without going through a Delphi—at this final stage of the game”— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

“Most scientists now reject the idea that sex is strictly binary. The likes of Nature, possibly one of the most prestigious scientific journals in the world, has noted that “the research and medical community now sees sex as more complex than male and female.””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“And, while it’s true that most people inherit either XX (typically female) or XY (typically male) chromosomes at conception, declaring that sex is determined so early is overly simplistic.”— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“the IOC has fought back with a mix of high moral dudgeon and irrelevant claims about, for instance, the letter on Khelif’s passport. ... Khelif had been previously disqualified from competition by the International Boxing Association on the basis of (somewhat vaguely described) testing”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

“Anne Fausto‐Sterling's suggestion that the prevalence of intersex might be as high as 1.7% has attracted wide attention... If the term intersex is to retain any meaning, the term should be restricted to those conditions in which chromosomal sex is inconsistent with phenotypic sex, or in which the phenotype is not classifiable as either male or female. Applying this more precise definition, the true prevalence of intersex is seen to be about 0.018%, almost 100 times lower than Fausto‐Sterling's estimate of 1.7%.”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

““A level playing field is a fallacy,” says Dr. Myron Genel... “There's so many other factors that may provide a competitive advantage,” Genel says. “It's very hard to single out sex as the only one.””— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

““Both girls are on hormone suppression, which negates any competitive advantage due to testosterone... My understanding is that after a year on hormone suppression the advantages of testosterone are mitigated,””— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“With regard to the gender dysphoria desistance debate — we’ll get there — the episode claims that “The only study we’ve found that zoomed in on kids [who identified strongly as being trans fairly early in life]… found that out of 45 of them… 44 grew up to be transgender.” Here Science Vs accidentally fabricated and published a study result. There is no such study.”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“a lot of these studies suffer from one of two confounds: First, they are posthumous brain studies in which the owner of the brain had taken hormones, which could itself change the brain. Second, the studies don’t control for the possibility that observed differences are at least partially related to sexuality”— (Some Of) Your July 2025 Questions, Answered

“I argued that the authors were making a plainly false claim: that the reviews in question... graded the studies based in part on whether they were RCTs. If you simply look at the two papers in question, it’s clear that this is wrong: Rather, the reviewers used a grading scale specifically designed for non-randomized studies.”— Two Unsurprising Updates On The Ongoing Self-Immolation Of Expert Authority

“It’s like the NYT looking for a physicist who doesn’t believe in gravity or a[n] oceanographer who doesn’t believe in climate change. Such cranks or bigots ain’t news”— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

“On YouTube, there’s a clip from 2013 of Graddick introducing trans-identified boys Jazz Jennings and Coy Mathis—ages twelve and six at the time—on stage at GLAAD’s annual awards gala. “Earlier tonight I was asked by Ketel One who was my inspiration, and I wrote the both of you,” he told them.”— Former GLAAD President: We Were Wrong to Medicalize Trans-Identified Children

How It Spread

The assumption spread through endorsements by major U.S. medical organizations including the American Academy of Pediatrics, American Medical Association, and Endocrine Society, whose policy statements were cited in guidelines, media, and court briefs as representing settled consensus. These documents often linked to studies lacking direct outcome data on youth mental health, yet carried institutional authority that shaped pediatric practice and public perception for years. ^[38][57]

Mainstream media and prestige outlets amplified the narrative. CNN inserted near-identical language describing gender-affirming care as medically necessary and evidence-based into dozens of articles on state bans. The New York Times, New York magazine, and Science Vs podcast presented affirmation as uncontroversial while framing skepticism as misinformation or transphobia, sometimes misrepresenting desistance research or study results. ^[60][26][38]

Social and professional pressure discouraged dissent. Clinicians and researchers questioning the evidence faced accusations of bigotry, retracted reviews, and career warnings, as seen in the McMaster University controversy over collaboration with the Society for Evidence-Based Gender Medicine. Whistleblowers like Jamie Reed were initially dismissed as fabricators until detailed corroboration emerged. ^[49][50][67]

Guidelines from WPATH and the Endocrine Society shaped clinic protocols worldwide, formalizing the Dutch model then loosening age restrictions. U.S. clinics often moved faster than the original protocol, offering blockers on first visits in some cases, while European countries began restricting access after their own evidence reviews. ^[33][40]

▶ Supporting Quotes (82)

“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?

“Many have been diagnosed with a condition known as “gender dysphoria” and offered a treatment approach known as “gender-affirming care.” ... Thousands of American children and adolescents have received these interventions.”— Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices

“In response, medical interventions including puberty-suppressing hormones, cross-sex hormones, and surgical procedures have been increasingly provided to children and adolescents.”— Message Pediatric Gender Dysphoria Treatment

“All studies were observational cohort studies, usually using retrospective record review (14); all were published in the previous 11 years (median 2018).”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“During this period, clinical practice progressed amid growing patient demand and an evolving understanding of the evidence base, particularly with respect to long-term outcomes in pediatric and adolescent populations.”— Position Statement on Gender Surgery for Children and Adolescents

“providers who work with TGNC youth and their families should endeavor to offer ethically sound, patient-centered, gender-affirming care based on the best currently available evidence.”— Ethical Issues in Gender-Affirming Care for Youth

“This changed in 2012 when WPATH published Version 7 of its Standards of Care (SOC 7) (WPATH 2012). The new paradigm asserted that patients, including children and adolescents, knew best what they needed (Levine 2018).”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“World Professional Association of Trangender Health’s transformation into a politically driven entity.”— Transsexualism is pseudoscience

“Media coverage of this phenomenon has exploded since 2015 across the West, including in Canada.”— THE POLITICS OF THE CULTURE WARS IN CONTEMPORARY CANADA

“a powerful “liberal misinformation bubble” surrounding youth gender medicine. This has been reinforced by many authoritative figures’ incessant repetition of the unsupported claim that children are likely to kill themselves unless they transition. ... a former head of the World Professional Association for Transgender Health has likened skepticism of youth gender medicine to Holocaust denial.”— How to Confront Highbrow Misinformation

“The number of adolescents referred to specialised gender identity services (gender-referred adolescents) to consider GR has increased significantly in the 21st century.”— All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study

“These claims have been retweeted thousands of times by other campaigners and members of the public. They have been repeated by some leading journalists, though there is nothing to suggest that they have examined the evidence for themselves. They too have adopted the language of “dying children”.”— Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report

“parental reports are frequently the sources of research published by the proponents of gender affirmation”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“While these claims about gender identity did not attract systematic scrutiny at first, they now have become the subject of criticism from a growing number of scientists, philosophers and health workers.”— No One Is Born in ‘The Wrong Body’

“Howard’s article is illustrated with a photo of a t-shirt that reads “Leave Trans Kids Alone You Absolute Freaks.” It seems like the article’s raison d’être is for Jonathan Howard to explain what a good man he is”— How Can Doctors Like This Provide Competent Care To Their Patients?

“Many established activist-clinicians have (in my opinion) impeded our knowledge of this subject by loudly proclaiming that these kids were always trans, their parents just didn’t notice, and so on. They have basically denied that this is actually a new type of gender-dysphoric young people.”— Your December Questions, Answered (1 of 2)

““Cass and her minions demanded RCTs, which are impossible in this area of medicine!” was a false rumor about the Cass Review that some activists began spreading to discredit it almost as soon as it came out”— If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes

“Diana Tordoff discussed her and her colleagues’ findings on Science Friday... The post has 13,400 upvotes and more than 1,700 comments, many of them remarking on what an important finding it is.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“Collin posted the study to /r/science on Reddit with the headline “Transgender and nonbinary youth who received gender affirming medical care experienced greatly reduced rates of suicidality and depression over the course of 12 months.””— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“The counterarguments to her position are so blazingly obvious to anyone who has ever interacted with a child or a teenager that it’s an act of willful editorial neglect to simply ignore them entirely.”— Andrea Long Chu’s ‘New York’ Cover Story About Trans Kids Is, Above All Else, Lazy

“With the cultural tides shifting, an increasing number of parents followed suit and transitioned young kids — in some cases, as young as age 3. This is generally known as the “affirming” approach.”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“Landon was not an independent, third-party voice in all this; rather, she co-chairs a trans youth support group called Transforming Family with Olson-Kennedy and Dr. Aydin Olson-Kennedy”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“Writing in a New York Times article that was highly critical of the Cass Review, Lydia Polgreen positively referenced and linked to the white paper, noting that it was authored by a team that included “two Yale professors.””— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“that McNamara filed a version of it in the legal case Boe v. Marshall.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“having an outsize influence on the national debate about this subject (both via their comments to media and their expert testimony in court cases)”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“Cheung et al. argue that McNamara et al. “was written for a primarily litigious, rather than academic, purpose” — and that this can help explain why it is so misinformed and, in some cases, factually challenged.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“the weekly Swedish documentary program Mission: Investigate broadcast an alarming episode about a scandal”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“It’s clear, in light of all these issues, that hard age caps on transition run counter to the opinion of many professionals in this area, and that they could cause serious harm.”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“Instead, Science-Based Medicine has fallen into the exact same trap as numerous mainstream news outlets, violating some of its founding principles in the process... SBM defaults to just about every activist trope that has come to dictate the terms of this debate in progressive spaces.”— How Science-Based Medicine Botched Its Coverage Of The Youth Gender Medicine Debate

“that culminated in the retraction of a positive review by Harriet Hall (reposted here) and a four-part followup series criticizing the book.”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“On the basis of these findings, the study is being widely touted, both by most mainstream media outlets that have covered it and by the authors themselves, as solid evidence that hormones improve the well-being of trans youth.”— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

“A number of media outlets echoed this narrative.”— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

“Science Vs continues to present this study to the public as solid recent evidence for the efficacy of puberty blockers and hormones.”— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“Back in 2013, when the DSM released its fifth edition... seemingly everyone covered this story wrongly. These headlines were everywhere: “APA Revises Manual: Being Transgender Is No Longer A Mental Disorder” went the ThinkProgress headline. “Being transgender no longer a ‘mental disorder’: APA,” went MSNBC’s.”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“there was a huge increase the last couple of years. But [it turned out that] many of these girls were actually detransitioning later on... around 2013–2014 it skyrocketed.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“There’s no area of the gender dysphoria discussion where some journalists and activists more frequently disseminate misleading information than in the conversation about desistance.”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“That’s how the meme of an 80% desistance rate, which is probably an overestimate, caught on. But the desistance literature has been critiqued harshly for years by some activists and journalists”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“Bergner makes it clear that this sort of vagueness often suffuses cases like Salem’s... To make the doubt and dismissal faced by nonbinary people worse, some physicians and surgeons who are committed to treating binary trans patients with hormones and surgery are wary of doing the same for the nonbinary.”— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“a tweet that helped spark what would become a bit of a Twitter pileon centered on Sohn’s piece (GNC means “gender nonconforming”— Is The Process Of Science Reporting Inherently Transphobic?

“After reaching out to a subset of the gender clinicians I’d relied on to walk me through these issues in the past... I encountered similar sentiments.”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“A few articles have been published recently that mess up really key stuff, and I simply want to show just how badly they misfire so as to demonstrate, once more, how little quality-control is going on in this area of media.”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“the steady stream of confused and confusing writing published on this subject in important places”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“Lavery’s article is written as though radical feminists who despise trans people are the one secretly pulling the strings of the British legal system”— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

““Top surgery drastically improves quality of life for young transgender people, study finds,” read the CBS headline from September 27.”— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

““They said that by going to a SEGM meeting I’m now being labeled on social media — which I don’t look at, so I don’t know — but they were saying I’m being labeled as an anti-trans activist.””— The Disaster At McMaster Part 2: My Interview With Gordon Guyatt

“I can’t say for sure, but I think the answer has something to do with browbeating, bullying, professional threats, and lies... As recommended by community advocates, we have also personally made a donation to Egale Canada’s legal and justice work”— The Disaster At McMaster, Part 1

“powerful people kept passing the buck and deferring to “experts” whose views on this, in retrospect, were quite radical and out of step with the available science”— (Some Of) Your July 2025 Questions, Answered

“In the latest Trump administration attack on science and transgender rights, the Department of Health and Human Services has issued a new report attempting to promote thoroughly discredited and dangerous “conversion therapy” programs for transgender youth.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

““The finger was already on the scale when this report was commissioned,” says Kellan Baker”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“some on the left treated it as an astonishingly bad-faith act of illogic... One of the legal thinkers I was referencing was Mark Joseph Stern of Slate, whose response to Skrmetti was headlined “John Roberts’ Anti-Trans Opinion Is a Garbled Mess. It’s Easy to See Why.””— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“Having a trust-falling-through-the-floor-of-the-sub-basement moment (again!) reading liberal legal writers’ takes on Skrmetti.”— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“The release was laden with other, similarly rosy quotes from other members of the team, including Olson-Kennedy.”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

“the leading pediatric organization in the country is claiming that there is “a limited but growing body of evidence” to support one particular protocol, and then citing two publications that can’t buttress this claim (because they include no data), and a third that, while offering some data, really isn’t up to this sort of task.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping Implode Their Own Credibility (Part 1 of 2)

“She has long criticized comprehensive psychological assessments prior to medical transition as unnecessary “gatekeeping” — “I don’t send someone to a therapist when I’m going to start them on insulin,” she told me in 2018”— Read My Story About A Major Detransition Lawsuit In The Economist

“He has built a career as an exceptionally successful DIY podcaster, probably one of the few self-made podcast millionaires... he’s been confident for quite some time that youth gender medicine “reduces both suicidal ideation and suicide attempts.””— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“if Scott Alexander’s concept of “isolated demands for rigor” had a mascot, it would be Michael Hobbes.”— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“it’s standard for outlets to provide reporters with guidance about accurate and appropriate language... You do not generally see the same complex sentence pasted over and over and over into news stories written by different authors”— Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

“Here’s what he sent back, in reverse chronological order. England’s health service... First on CNN: Major medical society... Record number of anti-LGBTQ bills... Gender-affirming surgeries”— Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

“Naturally, the authors don’t mention the highest quality evidence in question, which is — say it with me — the European evidence reviews. It is, and again I feel that déjà vu coming on, a shocking omission on the part of doctors writing in perhaps the most important journal of pediatrics in the world.”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“there is a wall of “anyone who asks questions about the evidence hates these young people” .… and people won’t look.”— Your October Questions, Answered

“The podcast argues that a major reason certain parents are skeptical of their kids transitioning, and in some cases pin their desire to do so on “social contagion,” is a website called 4thWaveNow that is skeptical of youth transition, and that my 2018 Atlantic article played a major role in spreading this idea to the masses.”— Why So Many People Told Me To Kill Myself This Weekend

“The average layperson might see that phrase, “2,000 scientific studies,” and be impressed. But setting aside the fact that quantity does not equal quality”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“It’s baffling and frustrating that, in 2023, the magazine’s editors are comfortable allowing their publication to claim both that there’s solid evidence puberty blockers help gender dysphoric kids”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“Half of transgender people aged 13 to 24 have seriously considered suicide in the past year, according to a 2023 nationwide survey released on May 1 by the Trevor Project”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“they enjoy the professional benefits of a high-profile publication on a hot-button issue that got some glowing media coverage.”— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“At some point, a strange game of internet telephone took hold. Reed’s original claim, that a child who seemed to identify as a number of things, only one of which was a helicopter, had been rushed too hastily onto hormones, morphed into something orders of magnitude stupider.”— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

“A tweet from the journalist and author Mark Harris neatly summed up the latter sentiment: “If you read the trans-clinic ‘whistleblower’ story that the trans-hating right wing (and a lot of people who should know better) seized on, you must read this deeply reported, fully sourced story about trans care for kids at that center,” he said, linking to the Post-Dispatch article. “Please share it!””— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

“If you click here you’ll see that a lot of people quote-retweeted Coleman. It’s a strange experience to read the quote-retweets, because there is almost universal agreement that Chait’s excerpt is egregiously bad”— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

“UW’s researchers and PR apparatus seeded the media with, which spread widely among liberal-minded consumers of science information eager for empirical ammunition.”— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

“Roberts was making a series of big public claims about a very well-regarded journalist: That she was suffering from a broken brain, that she had abandoned all of her journalistic virtues, and that she had accepted extremely flimsy evidence and reasoning.”— I Would Like To Thank Not Only David Roberts, But All The David Robertses Out There

“You replaced it with articles stating things such as the following... Do you think that Lovell's statement constitutes “high quality scientific evidence and reasoning”?”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“Sunday night, 60 Minutes aired a 14-minute segment on youth medical transition.”— What GLAAD and the ACLU Did This Week Is Disturbing, But Unsurprising (Update)

“the US Department of Health is very keen to bring the trans health agenda forward.””— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

“Both articles represent dead-end attempts to defend what has become a sacred goal of progressive science discourse — claiming that biological sex is too complicated for us to divide the vast majority of humans into “male” and “female””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“As The Washington Post reported: ... This comes after a flurry of online attacks spreading false claims about her gender.”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

“A bunch of journalists and activists have lately sought to muddle all this... Let’s start with a long feature in Bleacher Report... An article in The Nation about Yearwood”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“The producers appear to have made an error in interpreting a 2013 study that did not include any situation in which 45 deeply dysphoric kids were evaluated and 44 turned out to identify as trans in the long run.”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“This claim appeared in a top medical journal and echoed in a SCOTUS amicus brief in United States v. Skrmetti.”— Two Unsurprising Updates On The Ongoing Self-Immolation Of Expert Authority

“As a result of Caraballo’s tweet, Ryan got a series of furious text messages and emails, the most deranged ones accusing him of killing kids, doing journalism in a manner that would please the neo-Nazi Daily Stormer, telling him to kill himself”— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

“Graddick also led GLAAD’s efforts to educate the mainstream media on how to report on transgender people, including, most recently, the murder of Cemia Acoff, reports of whose death was bungled by local media in Cleveland. In November, the organization published a comprehensive report about transphobic violence and irresponsible media reporting called Doubly Victimized, that offered guidelines for mainstream media reports on transgender issues.”— Former GLAAD President: We Were Wrong to Medicalize Trans-Identified Children

Resulting Policies

U.S. medical organizations and many clinics treated puberty blockers, cross-sex hormones, and in some cases surgeries as standard care for gender dysphoric minors outside research settings, guided by WPATH and Endocrine Society standards that removed firm age minimums. This approach contrasted with policies in Sweden, Finland, England, and Norway, which by 2022-2024 restricted these interventions to clinical trials or select cases after determining risks outweighed uncertain benefits. ^[3][15]

Tennessee’s SB1 and similar laws in roughly 20 states banned the use of puberty blockers, hormones, and surgery to treat gender dysphoria in minors, prompting legal challenges arguing the statutes classified on the basis of sex. The Supreme Court upheld SB1 in United States v. Skrmetti in 2025, ruling it regulated medical care for a specific condition rather than discriminating by sex and therefore warranted only rational basis review. ^[54]

NHS England, following the Cass Review, ended routine puberty blocker prescriptions and limited cross-sex hormones, with no minors receiving blockers outside research after 2024. The Tavistock Gender Identity Development Service was closed and replaced by regional hubs emphasizing holistic mental health assessment. ^[6][60]

The Biden administration’s Department of Health and Human Services faced accusations of pressing WPATH to remove age minimums from Standards of Care 8 to align with political goals. The subsequent Trump administration commissioned the 2025 HHS evidence review that found very low quality evidence and recommended against routine medicalization of minors. ^[76][1]

▶ Supporting Quotes (60)

“the U.K. has banned the routine use of puberty blockers as an intervention for pediatric gender dysphoria.”— Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices

“medical interventions including puberty-suppressing hormones, cross-sex hormones, and surgical procedures have been increasingly provided to children and adolescents.”— Message Pediatric Gender Dysphoria Treatment

“Reporting centres broadly followed established international guidance regarding age of treatment and treatments used.”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“While earlier versions had minimum age requirements for adolescents to receive PBs, CSHs, and surgery, the current version does not. SOC 8 allows PBs and CSHs at the very start of puberty, which occurs on average at the age of nine to ten in girls ... Thus, according to the current WPATH guidelines, life-altering PBs and CSHs can be given to girls and boys as young as eight to nine years of age”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“it questions the scientific basis of trends in the treatment of children who do not identify with their biological sex.”— Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences

“Respondents, by a 2 to 1 ratio, want parents informed when children under age 16 change pronouns at school;”— THE POLITICS OF THE CULTURE WARS IN CONTEMPORARY CANADA

““The responses in the U.S. stand in stark contrast with Sweden, Finland, France, and the United Kingdom, which are issuing increasingly restrictive statements and policies, including bans on all medical transition of minors.””— AHCA: About AHCA

“the premise of gender affirmation, which demands that healthcare providers confirm an adolescent’s self-identification and facilitate access to any and all desired hormonal and surgical interventions”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“Yet instead of offering counseling, medical professionals now are commonly telling children that they may have been “born in the wrong body.” This new approach, called “gender affirmation,” makes gender dysphoria less likely to resolve”— No One Is Born in ‘The Wrong Body’

“Though I don’t treat trans patients often, I hope I do so kindly and capably.”— How Can Doctors Like This Provide Competent Care To Their Patients?

““The Cass Review on gender-affirming care, which has been used to justify bans in U.S. states, transgresses medical law, policy, and practice, which puts it at odds with mainstream U.S. expert guidelines,” claims the abstract.”— If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes

“They received their care at Seattle Children’s Gender Clinic.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“experts didn’t generally recommend full-blown social transition for most minors. In the States, the few youth gender clinics mostly followed a version of the so-called Dutch Protocol”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“Olson-Kennedy noted that at that point, Breen hadn’t yet seen a therapist, but that her parents had.”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“Now, by the time the review was published, the NHS had already effectively banned the use of puberty blockers as a treatment for gender dysphoria and tightened the policies surrounding the prescription of cross-sex hormones to gender-dysphoric youth.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“They argue that McNamara et al. employ “a ‘shotgun’ argumentation approach” in which “an argument is made to seem more persuasive not by the quality but volume of arguments (fallacious or otherwise)[.]” This may be “well suited to litigious, adversarial settings,””— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“youth gender medicine at Karolinska University Hospital”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“a spokeswoman from Freedom for All Americans... told me that the organization was tracking state bills in three different categories: bills that would criminalize medical providers for providing these services to minors (in Florida, Missouri, South Dakota, Oklahoma, Colorado, and Kentucky), bills that would subject providers to a loss of their licenses (in Illinois, two in Missouri, and South Carolina), and bills that would label such care as child abuse (in New Hampsire and two in Missouri).”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

““This research is highly significant in scope as it is the first longitudinal study collecting data — assessing both physiologic and mental health outcomes — to evaluate commonly used clinical guidelines for transgender youth in the U.S.””— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

“the research team has spent years following a cohort of kids who have been administered puberty blockers or hormones at four participating clinics.”— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

““Recent research demonstrates that integrated affirmative models of care for youths, which include access to medications and surgeries, result in fewer mental health concerns than has been historically seen among transgender populations.””— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“after you get diagnosed with F64.9, I think it is, you can start puberty blockers... the second diagnosis code... F64.0, which is gender... not gender dysphoria, but trans... meaning you are a trans person, and you need affirmative treatment.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“You don’t go on puberty blockers because you are trans — you go on them because you have severe and persistent gender dysphoria that puberty could exacerbate.”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“it appears there are only a tiny handful of clinicians in the country capable of delivering this level of care. Because gender dysphoria is such a difficult, fraught subject, and so few clinicians have serious experience or training in treating it, something of a Wild West may be developing when it comes to clinical care for this population.”— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“these laws are an extremely bad idea for many rather obvious reasons, and could do serious harm to TGNC youth. They reflect a disturbing attempt on the part of politicians to insert themselves between doctors and their patients.”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

““Children under 16 with gender dysphoria are unlikely to be able to give informed consent to undergo treatment with puberty-blocking drugs.””— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

“A lot of doctors are performing these operations in the States... the youngest age at which surgery occurred is 13”— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

““I did not know about this agreement until the controversy got going.””— The Disaster At McMaster Part 2: My Interview With Gordon Guyatt

“our prior work has been used in exactly this highly problematic way... denying care such as puberty blockers and hormone replacement therapy to TGD individuals”— The Disaster At McMaster, Part 1

“especially when federal dollars are at stake and a GOP Congress has subpoena power”— (Some Of) Your July 2025 Questions, Answered

“In recent years, more than half of all states, including Florida and Tennessee, have implemented policies restricting or banning gender-affirming care for minors.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“Soon after taking office in January, Trump gave HHS a 90-day deadline to publish the review in an executive order titled “Protecting Children from Chemical and Surgical Mutilation,””— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“Tennessee’s SB1, a ban on puberty blockers, hormones, and surgery as treatments for minors with gender dysphoria in that state.”— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“this arrives at a time of maximal controversy on this subject in the U.S., with a major Supreme Court decision expected this month that could permanently solidify U.S. states’ ability to ban or severely restrict youth gender medicine.”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

“which is still considered to be the AAP’s active guidance on the subject of youth gender medicine. ... in 2023 the AAP reaffirmed its statement.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping Implode Their Own Credibility (Part 1 of 2)

“under Olson-Kennedy’s care, received puberty blockers at 12, testosterone at 13, and a double mastectomy at 14.”— Read My Story About A Major Detransition Lawsuit In The Economist

“in the context like the United States, where, as Reuters reported in 2022 (more on which soon), it’s hard to find a”— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“this exact sentence... appear over and over and over... England’s health service to stop prescribing puberty blockers... Trump-appointed judge blocks parts of Indiana ban... 19 states have laws restricting gender-affirming care”— Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

“Georges and her colleagues argue that GOP laws seeking to restrict access to youth gender medicine “deny children access to routine health care that has been shown to decrease dramatically high rates of suicide and depression for TGD youth.””— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

““If you are trans, I believe you,” says A.J. Eckert, the medical director of Anchor Health Initiative in Connecticut. Eckert is wary of psychologists who follow the guidelines by completing a comprehensive assessment before recommending medical intervention for youths.”— Why So Many People Told Me To Kill Myself This Weekend

“Due to widespread misinformation about medical care for transgender and gender-diverse teens, 18 states have passed laws or instituted policies banning gender-affirming care.”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“the UK’s National Health Services announced that going forward, as the BBC put it, “Puberty blockers will only be prescribed to children attending gender identity services as part of clinical research.””— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“The healthcare systems of Finland and Norway have gone so far as to call these treatments “experimental,” as did the Swedish team behind a major, just-published systematic review. The UK’s National Health Service hasn’t quite gone that far, but late last year it proposed new guidelines”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“this is major surgery being performed on young or very young people”— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“Reed, who sought whistleblower protections under Missouri state law before coming forward, said in her article and affidavit that the clinic’s practices were deeply irresponsible and likely to harm its patients.”— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

““In some cases, a more extended assessment process may be useful, such as for youth with more complex presentations (e.g., complicating mental health histories (Leibowitz & de Vries, 2016)), co-occurring autism spectrum characteristics (Strang, Powers et al., 2018), and/or an absence of experienced childhood gender incongruence (Ristori & Steensma, 2016).””— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

““Gender-affirming care is lifesaving care,” Collin says in it. “This care does have a great deal of power in walking back baseline adverse mental-health outcomes.”— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

“While reporting accurately on the controversy itself, she also discussed the exacerbating factors of the numerous ill-conceived Republican attempts to ban these treatments altogether.”— I Would Like To Thank Not Only David Roberts, But All The David Robertses Out There

“a scandal involving youth gender medicine at Karolinska University Hospital”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“framed by recent Republican attempts to ban youth medical transition at the state level — and clearly presented these laws in a quite negative light”— What GLAAD and the ACLU Did This Week Is Disturbing, But Unsurprising (Update)

“these specific listings of ages, under 18, will result in devastating legislation for trans care.””— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

““ ‘Female’ means a person belonging, at conception, to the sex that produces the large reproductive cell,” reads the order. “ ‘Male’ means a person belonging, at conception, to the sex that produces the small reproductive cell.””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“the passport guidelines, the administration has since clarified, will apply only to new and renewed passports.”— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“Investigators are looking into charges including gender-based cyber harassment and public insult. ... it received the case that Khelif filed with its special unit for combating online hate speech.”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

“Andraya Yearwood, a trans teenager running track in Connecticut who (after this article was published) finished second in the 55-meter sprint at the Connecticut women’s indoor track and field championships, with another trans girl taking the top spot. (The two have topped certain other recent events, as well.)”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“The citation here is to a brief filed in United States v. Skrmetti, the soon-to-be-decided SCOTUS case about youth gender medicine bans.”— Two Unsurprising Updates On The Ongoing Self-Immolation Of Expert Authority

“Don’t go looking to find sources that will support the story you’ve already decided to tell. Or fish purposefully for a contrarian “character.””— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

“GLAAD worked closely with the Colorado family of a transgender 6-year-old whose school refused to allow her to use the girl’s bathroom, filing a complaint with the state civil rights commission and elevating awareness about the situation.”— Former GLAAD President: We Were Wrong to Medicalize Trans-Identified Children

Harm Caused

Thousands of American and European minors received puberty blockers, cross-sex hormones, and surgeries with documented risks including infertility, impaired bone density, sexual dysfunction, cardiovascular issues, and surgical complications. One Swedish cohort showed adults who underwent gender reassignment had two to three times higher all-cause mortality than the general population, driven by suicide, substance abuse, and external causes. ^[13][3]

Clementine Breen underwent puberty blockers, testosterone, and double mastectomy after minimal psychological screening and later detransitioned, alleging negligence in a lawsuit supported by clinic records. Jazz Jennings, a prominent case promoted by advocacy groups, experienced complications from genital surgery and ongoing severe mental health struggles. Whistleblower accounts from clinics described rapid progression to medicalization for youth with complex comorbidities including autism, trauma, and same-sex attraction. ^[28][58][82]

Studies reported persistent or elevated suicidality post-treatment. In a 315-person hormone cohort, two suicides occurred within a year, producing a rate far exceeding general youth statistics, while systematic reviews found no reliable evidence that affirmation reduced completed suicide. Social transition was associated with worsened parent-child relationships and mental health in some parental report data. ^[37][14][16]

Critics of the assumption faced professional and personal repercussions including retracted articles, doxxing, and accusations of bigotry that chilled debate. Conversely, proponents argued that restrictions themselves caused harm by denying care to distressed youth and increasing suicide risk, though European reviews found no clear causal surge in suicides after policy changes. ^[1][14]

▶ Supporting Quotes (84)

“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?

“Thousands of American children and adolescents have received these interventions. ... irreversible endocrine and surgical interventions on minors with no physical pathology. These interventions carry risk of significant harm”— Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices

“Treatment Harms: Known and plausible harm risks include: Infertility and sterility; Sexual dysfunction; Impaired bone density development; Adverse cognitive effects; Cardiovascular and metabolic disease; Psychiatric conditions; Surgical complications.”— Message Pediatric Gender Dysphoria Treatment

“Risk-Benefit Analysis: The evidence demonstrates an unfavorable risk-benefit profile for chemical and surgical interventions in children and adolescents with gender dysphoria.”— Message Pediatric Gender Dysphoria Treatment

“Most changes to health parameters were inconclusive, except an observed decrease in bone density z-scores with puberty suppression, which then increased with hormone treatment. There may also be a risk for increased obesity.”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“systematic reviews and evidence reassessments have subsequently identified limitations in study quality, consistency, and follow-up alongside emerging evidence of treatment complications and potential harms.”— Position Statement on Gender Surgery for Children and Adolescents

“The process of gender transition carries significant risks. Not only does medical and surgical transition result in permanent, disfiguring alterations to the body but there are significant risks of complications and adverse effects.”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“Historically, the standard of care worldwide for children and adolescents with GD has been counseling and watchful waiting (Laidlaw, Cretella and Donovan 2019; Van Meter 2019). With time, a large majority of these young people would become comfortable with their biological sex (Drummond et al. 2008; Singh, Bradley and Zucker 2021; Steensma et al. 2013; Van Meter 2019; Wallien and Cohen-Kettenis 2008).”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“Transgender Health Outcomes 73”— Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences

“Canadians oppose gender reassignment surgery for under-16s by 4 to 1;”— THE POLITICS OF THE CULTURE WARS IN CONTEMPORARY CANADA

“Studies have reported increased mortality rates in adults diagnosed with GD, with rates of up to two to three times those of the general population, both in patients who proceeded to GR and those whose treatment status was not disclosed. This elevated mortality in this population has been associated with ischaemic heart disease, cancer and external causes, such as substance abuse and suicide.”— All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study

“Among gender-referred adolescents, self-harming thoughts, self-injurious behaviours and suicide attempts are common, with a prevalence of up to 50% of the patients.”— All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study

“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. [...] One risk is that young people and their families will be terrified by predictions of suicide as inevitable without puberty blockers”— Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report

“Mental health of youth deteriorated following gender transition”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“Over 5 in 10 caregivers referred to gender clinics felt pressures to support gender transition”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“If aggressive transition options are pursued early in puberty, the combination of puberty-blocking drugs, followed by cross sex hormones, will result in permanent infertility. The growing population of transgender-identifying high school students now is estimated to comprise about 2% of all students—a three-fold increase over the baseline 0.5% figure cited above. Many adolescents now are presenting to gender clinics, with some clinics seeing a 10-fold increase in new cases. Not surprisingly, reports of transition regret, and de-transition, are growing in number.”— No One Is Born in ‘The Wrong Body’

“There remains considerable uncertainty regarding the effects of puberty blockers in individuals experiencing gender dysphoria”— Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis

“individual clinical research studies have inconsistently demonstrated benefit, and systematic evidence reviews have found the evidence in this field is comprised of studies with significant quality issues”— Reevaluating gender-affirming care: biological foundations, ethical dilemmas

“puberty blockers appear to have little influence”— Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis

“Imagine this patient asking him, a trusted, prestigious figure, if hormones are the right decision. Imagine this doctor thinking back to the abstract of one since mostly debunked paper and nodding, assuring this patient he is making the right choice.”— How Can Doctors Like This Provide Competent Care To Their Patients?

“because based on what we know about suicide it could be a self-fulfilling prophecy. There really is no solid evidence to support such a simple causal relationship”— Your December Questions, Answered (1 of 2)

“If The New England Journal of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes”— If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes

“The kids in the study arrived with what appear to be alarmingly high rates of mental health problems, many of them went on blockers or hormones, and they exited the study with what appear to be alarmingly high rates of mental health problems.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“Nor do the authors seem to notice that by the end of the study, the no-GAM group has dwindled to a grand total of six kids who reported mental health data, as compared to 57 in the group receiving treatment.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“(In the monograph, deMayo et al. note that 86% of the young people in their sample have started blockers and 68% have started hormones.)”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“Breen detransitioned after receiving puberty blockers, hormones, and a double mastectomy while under Olson-Kennedy’s care.”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“This white paper has spread far and wide, and has been treated by some as a definitive debunking of the Cass Review.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“experts have mortgaged their credibility on this issue... The public has a right to expect that such a highly respected, frequently consulted group will be well-informed”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“they are spreading misinformation about serious medical treatments often administered to highly vulnerable youth in a climate of political toxicity and research uncertainty.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“an alarming episode about a scandal involving youth gender medicine”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“the growing number of American families who face really difficult choices about puberty blockers and hormones that they are forced to make under a condition of terribly insufficient evidence.”— How Science-Based Medicine Botched Its Coverage Of The Youth Gender Medicine Debate

“You can’t just disseminate false and professionally damaging claims about people you dislike.”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“Eckert also commits an admittedly minor act of plagiarism.”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“there’s a reasonably strong case to be made that the positive results reported in [the NEJM paper] can be at least partially explained by the sort of statistical cherry-picking that tends to generate wobbly findings.”— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

“two participants died by suicide. In the body, they write that “one [suicide occurred] after 6 months of follow-up and the other after 12 months of follow-up.” ... this figure was about 317 suicide deaths per 100,000 patient-years in the NEJM study.”— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

“kids who had severe psychiatric problems, including suicidality, were excluded from the study at the outset... And yet, there were still two suicides.”— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

“This is a profoundly serious claim — an invocation of every parent’s worst nightmare — so one would hope that it’s backed by nothing but ironclad evidence. But that isn’t the case.”— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“It does a disservice to trans people and their advocates to spread false information about the current situation... trans people who seek medical care like hormones or surgery will, if properly diagnosed, likely be tagged with a mental-health diagnosis.”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“some of their patients were suffering from quite severe side effects, and they didn't tell this to the public... effects on their skeletons, they had other side effects, which were also quite severe.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“a lot of teenage girls — or born girls — that were seeking transgender healthcare... many of these girls were actually detransitioning later on.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

““I’ve actually had patients with parents pressuring me to recommend their kids start hormones,” Sharon said.”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“the Toronto clinic was shut down and its staff fired in late 2015 partially as a result of false and unverified rumors spread about its practices”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“Salem’s breasts had grown. The plan was to buy a sports bra both for exercising and ‘to compress, because sometimes’ — though the hormones seemed a success on most days — ‘I’m not a fan of my breasts.’”— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“it’s becoming horrifying the extent to which many mainstream outlets and journalists are, for the most part, abdicating any responsibility to guide readers through this stuff in a reasonable, evidence-based way”— Is The Process Of Science Reporting Inherently Transphobic?

“There’s a risk parents will try to prevent kids with genuinely severe GD — GD that will not go away in time — from transitioning out of a misguided belief that they will desist.”— Is The Process Of Science Reporting Inherently Transphobic?

“let’s say a kid who has been competently diagnosed with severe gender dysphoria goes on blockers at 11, but is in, or moves to, a state that passes a ban on cross-sex hormones for anyone who isn’t yet 18 years old. Seven years on puberty blockers would likely be unsafe”— Why The Hard Age Caps On Youth Gender Transition Being Proposed By Conservatives Are A Very Bad Idea

“Remember that every time one of these articles is published, more people become newly misinformed about the small subset of things we know, and the much larger subset of things we don’t know, about gender dysphoria. At a time when American culture is very interested in all sorts of questions of gender and identity and gender identity, and when record numbers of kids are showing up at gender clinics around the world, the spread of this type of misinformation is a problem for obvious reasons.”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“anyone on the left who advocates for caution or critical thinking with regard to kids and teenagers taking puberty blockers or hormones is likely to encounter fierce pushback, unfair insinuations, and career or reputational damage.”— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

“three months is a very short follow-up period for this sort of major surgery... zero validated mental health measures: There is nothing on anxiety, depression, or suicidality.”— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

““We haven’t even expressed any skepticism ourselves, and have been under attack, okay? So it’s an extremely polarized environment, no question about that. And you know, it’s warfare on both sides, as far as I can see.””— The Disaster At McMaster Part 2: My Interview With Gordon Guyatt

“his repeated use of the term traumatized and its variants to describe the effect of all of this on his younger colleagues... a long-running collaboration is being torched... We will no longer accept funding from SEGM”— The Disaster At McMaster, Part 1

“engage in prima facie reckless practices toward vulnerable youth, and on and on and on”— (Some Of) Your July 2025 Questions, Answered

“threatened to revoke federal funding from hospital clinics that provide gender-affirming care to minors.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“the answer is not a patchwork system similar to the post-Dobbs abortion landscape, where access to youth gender medicine depends on what state you’re in.”— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“The kids in this study had an alarmingly high suicide rate... Most of the improvements the cohort experienced were small.”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

“As we have seen with immunizations, bypassing medical expertise and scientific evidence has real consequences for the health of America’s children.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping Implode Their Own Credibility (Part 1 of 2)

“Clementine is a 20-year-old UCLA student who, under Olson-Kennedy’s care, received puberty blockers at 12, testosterone at 13, and a double mastectomy at 14. Breen... made a number of damning allegations about the care she received at Olson-Kennedy’s clinic, many of which are substantiated by Olson-Kennedy’s own notes”— Read My Story About A Major Detransition Lawsuit In The Economist

“That study showed that those who had transitioned had a higher rate of suicide than a matched control group.”— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“CNN writers... are effectively outsourcing their own judgment... a CNN reporter who does develop doubts about youth gender medicine is likely to be deterred from investigating further... there’s absolutely no reason to take CNN.com seriously on this issue”— Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

“Each case of lackluster journalism or science is different, but the most common theme is omission. Peer-reviewed articles on this subject regularly omit key information about their data ... while articles and segments produced for popular audiences by both journalists and academics in this space routinely ignore the fact that a number of countries in Europe have found, via systematic evidence reviews, that the evidence base for youth gender medicine is lacking.”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“It appears to me that it is not medicine, it’s pseudo-medicine.”— Your October Questions, Answered

“(An incident like this is also one of Jamie Reed’s key accusations about the quality of care at the St. Louis clinic where she turned whistleblower.)”— Why So Many People Told Me To Kill Myself This Weekend

“why make it such a cakewalk for the Joneses of the world? Why give people easy excuses to abandon mainstream sources of knowledge?”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“Journalists and pundits are utterly failing to disseminate accurate information about very serious treatments, in some cases straightforwardly misleading their audiences — among them parents trying to make medical decisions for kids who are too young to consent on their own”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“we are talking about a very vulnerable population.”— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“In the eyes of a number of fairly high-profile liberal journalists, the detail about the helicopter turned Reed into an instant punchline — not just a liar, but a hackish one.”— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

“If you obscure or fail to turn up these relationships, you are denying your readers information to which they are entitled.”— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

“If journos can’t follow WPATH’s lead without getting attacked by their colleagues, coverage of this issue will be impossible. Which is maybe the point?”— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

“parents will wrongly believe that these blockers and hormones significantly ameliorate suicidality, which could lead to terrible results.”— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

“This sort of legislation only makes it harder to have a thoughtful, evidence-based conversation about this area of medicine.”— I Would Like To Thank Not Only David Roberts, But All The David Robertses Out There

“Speaking of editors, it appears that there have been none at SBM other than the original five... he would have been shocked, probably to the point of resigning, when you published the embarrassments by Lovell and Eckert and when you banned Andy Lewis from commenting.”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“The response to 60 Minutes' segment on detransitioners is as predictable as it is depressing”— What GLAAD and the ACLU Did This Week Is Disturbing, But Unsurprising (Update)

“It’s all about messaging and marketing.””— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

“The EO does not “strip[ ] federal recognition of the gender identity of some 1.6 million trans and nonbinary Americans.””— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“Gold medal-winning Olympic boxer Imane Khelif has filed a legal complaint in France for alleged cyber harassment.”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

“finished second in the 55-meter sprint at the Connecticut women’s indoor track and field championships, with another trans girl taking the top spot (The two have topped certain other recent events, as well.)”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“I’ve been worried, for a while, about the level of bias creeping into mainstream journalism about gender dysphoria, and the frequency with which major outlets make basic errors when covering this subject.”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“Jessica is defending herself against the charge that she is mentally ill. She is pointing to a biological cause of her need to transition”— (Some Of) Your July 2025 Questions, Answered

“If the greatest minds in the country — the people who write NEJM articles and briefs for major SCOTUS cases — are incapable of reading the Cass Review... then what is their value to policy debates?”— Two Unsurprising Updates On The Ongoing Self-Immolation Of Expert Authority

“expressing regret that he beat cancer. ... He will suffer meaningful reputational damage, for sure.”— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

“this controversy reveals just how broken science journalism is right now — at least on certain hot-button subjects.”— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

“No word on where Coy Mathis is today, but we know how things turned out for Jazz. He had his puberty blocked at 11 and started cross-sex hormones at 14. At 17, he underwent bottom surgery, which was unsuccessful and required at least two surgical revisions. He now battles severe mental health issues and obesity.”— Former GLAAD President: We Were Wrong to Medicalize Trans-Identified Children

Downfall

The assumption began to face sustained challenge after 2018 when Lisa Littman published on rapid-onset gender dysphoria and European countries started independent evidence reviews. Sweden, Finland, and England commissioned systematic assessments that rated the quality of evidence for benefits as low or very low, leading to restrictions on routine use of blockers and hormones by 2022-2024. ^[16][3]

The 2024 Cass Review for NHS England systematically documented weak evidence, high rates of psychiatric comorbidity, and uncertainty about persistence, prompting England to end routine puberty blocker use outside research. Its findings were cited internationally and contributed to the closure of the Tavistock clinic. ^[6][59]

The 2025 HHS report, co-authored by experts including philosophers and clinicians, concluded that the evidence base failed to meet basic standards for risk-benefit analysis in minors and recommended against routine medicalization. Internal WPATH documents unsealed in litigation revealed political pressure to alter guidelines, further eroding confidence in claims of rigorous consensus. ^[1][76]

High-profile cases, whistleblower testimony, and detailed critiques of individual studies exposed data withholding, selective reporting, and misrepresentations in prominent publications. Former GLAAD president Herndon Graddick publicly stated in 2026 that medicalizing children had been a mistake. European countries and some U.S. states moved toward caution while U.S. medical organizations largely maintained their earlier positions, leaving the debate unresolved. ^[82][67][55]

▶ Supporting Quotes (87)

“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?

“This Review is published against the backdrop of growing international concern about pediatric medical transition. Having recognized the experimental nature of these medical interventions and their potential for harm (which has been inadequately studied, especially with respect to long-term outcomes), health authorities in a number of countries have imposed restrictions.”— Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices

“On November 19, 2025, the Department of Health and Human Services released a comprehensive, peer-reviewed evidence review titled Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices.”— Message Pediatric Gender Dysphoria Treatment

“United Kingdom: The 2024 Cass Review led to prohibiting puberty blockers outside clinical trials and substantially restricting cross-sex hormone access. No minor has satisfied eligibility criteria for cross-sex hormones under its updated National Health Service policies since the review's publication.”— Message Pediatric Gender Dysphoria Treatment

“Sweden: The National Board of Health and Welfare determined in 2022 that risks from puberty-suppressing and hormonal interventions likely exceed potential benefits. Sweden now restricts these procedures to research settings and recommends psychosocial support as first-line treatment.”— Message Pediatric Gender Dysphoria Treatment

“Finland: Guidelines issued in 2020 call for psychosocial support as the primary treatment, state that medical transition is an “experimental practice,” and restrict hormonal interventions to select cases.”— Message Pediatric Gender Dysphoria Treatment

“The evidence base for the outcomes of gender dysphoria treatment in adolescents is lacking. It is impossible from the included data to draw definitive conclusions regarding the safety of treatment. There remain areas of concern, particularly changes to bone density caused by puberty suppression, which may not be fully resolved with hormone treatment.”— A PRISMA systematic review of adolescent gender dysphoria literature: 3) treatment

“These reviews have not resolved earlier uncertainties regarding treatment benefit; in some areas they have contributed to a clearer understanding of potential harms, while also highlighting limitations of the available evidence.”— Position Statement on Gender Surgery for Children and Adolescents

“More recently, a number of international health systems and professional bodies initiated formal re-examinations of earlier clinical practice assumptions in response to changes in patient presentation and a growing uncertainty about the benefits of medical and surgical interventions.”— Position Statement on Gender Surgery for Children and Adolescents

“although available data describing the use of gender-affirming treatment options are encouraging, and the risks of not treating TGNC youth with gender dysphoria are evident, little is known about the long-term effects of both hormonal and surgical interventions in this population. To support ethical decision-making about treatment options, we encourage the development of a comprehensive registry in the United States to track long-term patient outcomes.”— Ethical Issues in Gender-Affirming Care for Youth

“An evaluation of the research and data reveals that gender-affirming care is not an ethical approach to the treatment of adolescents with gender dysphoria. It violates the principle of beneficence because gender transition has not been shown to be beneficial. It violates nonmaleficence because these interventions harm patients. It violates autonomy because ... there is inadequate informed consent.”— The Ethics of Gender-Affirming Care: An Evaluation of the Research

“The WPATH Files – an exposé of the World Professional Association of Trangender Health’s transformation into a politically driven entity.”— Transsexualism is pseudoscience

“More effort is called for to provide these people with the understanding, care, and support they need to lead healthy, flourishing lives.”— Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences

“Respondents, by a 2 to 1 ratio, do not want transgender women to enter women’s sports competitions;”— THE POLITICS OF THE CULTURE WARS IN CONTEMPORARY CANADA

“I was surprised when the Cass Review was published in the UK, clearly demonstrating that the scientific evidence for much of the mainstream discourse surrounding youth gender medicine is extremely weak.”— How to Confront Highbrow Misinformation

“Studies have reported increased mortality rates in adults diagnosed with GD, with rates of up to two to three times those of the general population, both in patients who proceeded to GR9–12 and those whose treatment status was not disclosed.13 14 ... however, the evidence base for these psychosocial benefits is weak.7 8”— All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: a register study

“In the 3 years leading up to 2020-21, there were 5 suicides, compared to 7 in the 3 years after. This is essentially no difference, taking account of expected fluctuations in small numbers, and would not reach statistical significance. In the under 18s specifically, there were 3 suicides before and 3 after 2020-21. [...] The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock.”— Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report

““There is very low certainty about the effects of puberty blockers on suicidal ideation.””— AHCA: About AHCA

“A new study examining 1,655 parental reports lends further credibility to the rapid onset gender dysphoria (ROGD) hypothesis”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

““While some of us have informally tended toward describing the phenomenon we witness as “adolescent-onset” gender dysphoria... Littman’s description resonates with our clinical experiences”— Study of 1,655 Cases Supports the "Rapid-Onset Gender Dysphoria" Hypothesis

“Historical data suggests that about 0.5% of children develop gender dysphoria... Reinforcing studies in the medical literature show that, as children get older, childhood-onset gender dysphoria resolves (i.e. ends) in most cases. As two authors put it in a 2016 International Review of Psychiatry article, “the conclusion from these studies is that childhood GD [gender dysphoria] is strongly associated with a lesbian, gay or bisexual outcome and that for the majority of the children (85.2%; 270 out of 317 [studied individuals]) the gender dysphoric feelings remitted around or after puberty.””— No One Is Born in ‘The Wrong Body’

“And of course the questions only mount when you look at the various systematic reviews published by European countries.”— How Can Doctors Like This Provide Competent Care To Their Patients?

“Byrne traced the source of that (not supported by the evidence) claim in “another myth of persistence” (2024), peer reviewed. For adolescent-onset even less is known... also the HHS report has discussion and more references.”— Your December Questions, Answered (1 of 2)

“the excellent writer Void if Removed published a thorough takedown on his Substack ... “In this short quote, the authors get the total number of studies wrong, the number of high quality studies wrong, the standard of evidence wrong, and the requirement for randomized-controlled trials wrong.””— If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes

“Among the kids who went on hormones, there isn’t genuine statistical improvement here from baseline to the final wave of data collection. At baseline, 59% of the treatment-naive kids experienced moderate to severe depression. Twelve months later, 56% of the kids on GAM experienced moderate to severe depression.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“They wanted to stay on background, but they confirmed to me that there was no improvement over time among the kids who went on hormones or blockers.”— Researchers Found Puberty Blockers And Hormones Didn’t Improve Trans Kids’ Mental Health At Their Clinic. Then They Published A Study Claiming The Opposite. (Updated)

“even more (almost 70 percent) oppose puberty blockers for trans kids.”— Andrea Long Chu’s ‘New York’ Cover Story About Trans Kids Is, Above All Else, Lazy

“While it’s not apples-to-apples, there’s a big difference between 6% and 18.4%, and taken together the two studies suggest that as the follow-up period grows, some of this study’s subjects are likely to develop significantly different feelings about their gender identities.”— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“While this idea is often laughed off by advocates and some researchers, the UK’s Cass Review, widely regarded as the most comprehensive effort yet published to evaluate the state of youth gender medicine, noted that “it is important to view [social transition] as an active intervention because it may have significant effects on the child or young person in terms of their psychological functioning and longer-term outcomes.””— Childhood Gender Research Is Increasingly Meaningless Because No One Knows What 'Gender' Means Anymore

“Breen is also suing Landon. Through her lawyer, Landon told me that all of her patient notes from her sessions with Breen were lost due to water damage.”— What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

“I ran significant segments of what follows by Dr. Gordon Guyatt, one of the godfathers of evidence-based medicine... Guyatt agreed that the expert witness, royalty, consulting, and authorship conflicts should have been disclosed.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine

“Many of the claims made by McNamara et al. are either recitations of activist talking points that have been debunked outright, or severe exaggerations”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“the systematic reviews of youth transition commissioned by the Cass Review and conducted by the University of York”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 2 (Corrected)

“Olson-Kennedy, one of the co-authors of this supposed debunking of the Cass Review, admitted to The New York Times’ Azeen Ghorayshi that she and her team are, due to the heated politics of this issue, sitting on apparently less-than-promising data about puberty blockers rather than publishing it.”— Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3

“Mission: Investigate broadcast an alarming episode about a scandal involving youth gender medicine at Karolinska University Hospital”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“All three articles contain major errors and misunderstandings and distortions, ranging from straightforward falsehoods to baffling omissions to the re-regurgitation of inaccurate rumors first circulated years ago.”— How Science-Based Medicine Botched Its Coverage Of The Youth Gender Medicine Debate

“by the time I published it, SBM had already begun issuing corrections as a result of my work (I tweeted out bits of my findings as I went and emailed the site’s top two editors”— Science-Based Medicine's Coverage Of "Irreversible Damage" Included About 19 Errors, False Claims About Three Sex Researchers, Made-Up Quotes, And Endless Misinformation

“of the eight key variables the researchers were most interested in — “gender dysphoria, depression, anxiety, trauma symptoms, self-injury, suicidality, body esteem, and quality of life” — the ones I bolded are not reported in the NEJM paper. That’s six out of eight, or 75% of the variables”— On Scientific Transparency, Researcher Degrees Of Freedom, And That NEJM Study On Youth Gender Medicine (Updated)

“In their study protocol... the researchers hypothesized that members of this cohort would experience improvement on eight measures... Then, in the published NEJM paper, the researchers changed their hypothesis and six of those variables were nowhere to be found.”— The New, Highly Touted Study On Hormones For Transgender Teens Doesn’t Really Tell Us Much Of Anything

“To the show’s credit, later in the month I got an email from the “Science Vs Team” in which they acknowledged they’d made an error: “We now realize we had misread the paper”— "Science Vs" Cited Seven Studies To Argue There’s No Controversy About Giving Puberty Blockers And Hormones To Trans Youth. Let’s Read Them.

“In neither the DSM-IV nor the DSM-5 is “being trans,” by the baseline, bolded definition, a mental disorder on its own.”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“they refer to the lack of scientific bases for the treatments. Usually, in Sweden... healthcare should be given on the basis of evidence... potential side effects that can be quite severe, like lowered bone density, different sorts of cancer, different sorts of heart disease”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“the medical doctors... knew that some of their patients were suffering from quite severe side effects, and they didn't tell this to the public.”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“the manual explicitly instructs clinicians not to wrongly diagnose merely gender nonconforming kids as having gender identity disorder.”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“You’d think he’d provide some hard evidence that such rampant misdiagnosis was going on at two of the most famous gender clinics in the world, but he doesn’t.”— How 'Science Vs' Accidentally Invented A Gender Dysphoria Desistance Statistic

“Delta, another teen from my article who was seen by Edwards-Leeper, fit more in that category and ended up realizing she wasn’t, in fact, trans. The caution urged by Edwards-Leeper and Delta’s own mom spared her what would have been unnecessary and potentially harmful medical treatments.”— What Does It Mean To Act With Compassion Toward Someone Seeking Out Medical Treatment?

“now in her early twenties, she no longer identifies as trans and believes that she was instead “struggling to deal with trauma, internalized homophobia, and social isolation””— Is The Process Of Science Reporting Inherently Transphobic?

““Low-quality evidence suggests that hormonal treatments for transgender adolescents can achieve their intended physical effects, but evidence regarding their psychosocial and cognitive impact are generally lacking.”— Is The Process Of Science Reporting Inherently Transphobic?

“How can Rolling Stone say that “under current guidelines gender-affirming hormones such as testosterone and estrogen are not even prescribed for children under the age of 16,” when two of the most important documents published on this subject don’t say anything of the sort?”— Three More Gender-Dysphoria Stories, Three More Sources Of Misinformation

“Foreign Policy didn’t post a correction, instead opting for a stealth edit that hides from the reader the fact that Lavery... didn’t initially understand the basics”— A Response To Foreign Policy's Deeply Misleading Article, "A High Court Decision in Britain Puts Trans People Everywhere at Risk" (Updated)

““Yeah,” he said via text. “It’s a weak correlation — so it’s all about how you interpret it... An interesting contributor, maybe! But not a massive deal.””— Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

““Can you point me to anything SEGM has written or — because they just deny that that is their view.””— The Disaster At McMaster Part 2: My Interview With Gordon Guyatt

“How could these signatories publish those articles and then turn around and describe the treatments in question as “medically necessary”? How can a treatment be medically necessary if no one knows whether it works as advertised?... his belief that members of the trans community were “in ecstasy” after he and his colleagues published the above statement. Perhaps most surprisingly, Guyatt denied even knowing, until recently, that the systematic reviews he co-authored were funded by SEGM”— The Disaster At McMaster, Part 1

“And they are flying — not for future Congressional hearings, but as part of ongoing investigations conducted by the Department of Justice”— (Some Of) Your July 2025 Questions, Answered

“Internal WPATH documents reveal that Baker et al. complied with all the mandatory steps of WPATH’s updated approval policy—from approving the conclusions before the manuscript was drafted to ensuring extensive WPATH engagement in the process and obtaining the final approvals.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping To Implode Their Own Credibility (Part 2 of 2)

“the Supreme Court’s 6–3 decision in United States v. Skrmetti, which upheld Tennessee’s SB1... In June 2025, the Court ruled 6-3 that SB1 regulated medical care for gender dysphoria, not sex, applying rational basis review.”— Here’s My Exchange With Slate’s Mark Joseph Stern About ‘United States v. Skrmetti’

“That controversy blew up last October, when Azeen Ghorayshi of The New York Times reported that Olson-Kennedy had told her, straightforwardly, that she was withholding the puberty blocker data for political reasons.”— A Critique Of “Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression”

“James Cantor wrote the most important fact-check of the Rafferty statement... Kathleen McDeavitt’s letter to the editor published in the Archives of Sexual Behavior sums this up nicely... the HHS report solidly sums up the present state of the controversy and the lack of evidence for youth gender medicine treatments.”— Expert Critics Of The HHS Report On Youth Gender Medicine Are Projecting—And Helping Implode Their Own Credibility (Part 1 of 2)

“now she’s being sued for medical negligence by a former patient, Clementine Breen, who insists that Olson-Kennedy did not provide enough gatekeeping... Breen and her attorneys acquired and shared with me... many of which are substantiated by Olson-Kennedy’s own notes”— Read My Story About A Major Detransition Lawsuit In The Economist

“this is “an area of remarkably weak evidence.””— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

““We cannot draw any conclusions on the basis of this single study about whether hormone therapy affects death by suicide among transgender people.””— Michael Hobbes Is Spectacularly Wrong About Youth Gender Medicine

“the NHS will no longer provide puberty blockers to young people, other than in research contexts... Sweden, Finland, the UK, and Norway have significantly scaled back access to these treatments for youth”— Why Is The Same Misleading Language About Youth Gender Medicine Copied And Pasted Into Dozens Of CNN.com Articles?

“we already know what the Europeans found about youth gender medicine”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“a systematic review of adult care commissioned by WPATH itself found that, well, let me borrow from myself, writing in UnHerd: The results, published in the Journal of the Endocrine Society in 2021, revealed that there is almost no high-quality evidence in this field of medicine.”— It’s Almost 2024 And Doctors Are Still Misleading The Public About Youth Gender Medicine

“I know lawsuits are starting, detransitioners are speaking up, evidence reviews are happening, and hopefully someone will someday soon start to look at long-term outcomes from those a decade ago or so.”— Your October Questions, Answered

“When working in gender clinics, we’ve also both received letters from therapists who had “assessed” patients they were referring to us. An astonishing number of these were nothing but a paragraph that stated the youth identified as trans, had dysphoria and wanted hormones, so that course was recommended.”— Why So Many People Told Me To Kill Myself This Weekend

“mere days after the UK’s National Health Services announced that going forward... Puberty blockers will only be prescribed... as part of clinical research... echoing similar ones made in Finland, Sweden, and Norway.”— Do You Want Alex Joneses? Because That’s How You Get Alex Joneses

“Every government-sponsored investigation of the evidence base for puberty blockers has come to the same conclusion: the quality of extant literature is so weak that no one really knows whether they are safe and effective for gender dysphoric youth.”— A Critique Of Scientific American’s Recent Article, “What Are Puberty Blockers, and How Do They Work?”

“the consent form also lists the instruments... 2. The Utrecht Gender Dysphoria Scale”— Here’s More Evidence That Youth Gender Medicine Researchers Might Be Hiding Unfavorable Data From The Public

“She pulled the file up on her phone and typed in the two most alarming sentences from the referring letter, verbatim. When I asked Reed if I could see this file she immediately emailed it to me... There, about halfway through various other notes and reflections on her situation, were the phrases in question: “Communist, attack helicopter, human, female, maybe non binary” “Hope for the transition to feel better in my body and no longer just in a flesh box””— Gender-Clinic Whistleblower Jamie Reed Has Provided A Detailed Account Of Her Most Controversial Claim, Including The Names Of Those Involved

“Reed said she didn’t know exactly what caused the official, permanent end of the employment relationship, but that based on what she described as Jones’ chronic performance issues, she thought it was very unlikely they would have been asked to come back.”— Journalists Are Exhibiting Far Too Much Credulousness Toward Jamie Reed’s Critics

“all three citations point to studies discussing, in one way or another, the possibility of a kid with GD symptoms not having GD or not settling into a long-term transgender identity.”— That Might Have Been The Strangest Thing That Has Ever Happened To Me On Twitter

“WE KNOW APPROXIMATELY NOTHING ABOUT HOW THE NO-TREATMENT KIDS WERE DOING 12 MONTHS LATER... according to one of the leading experts on said technique, was ill-suited to the task at hand.”— The University of Washington Is Putting Trans Kids At Risk By Distorting Suicide Research

“As Bazelon notes, the interim version of England’s so-called Cass Review found — this is the report’s own language — a “lack of available high-level evidence” for these treatments... In Sweden and Finland, I’ve noted repeatedly in this newsletter, the national healthcare systems independently came to the same determination and seriously scaled back access to puberty blockers and hormones for minors.”— I Would Like To Thank Not Only David Roberts, But All The David Robertses Out There

“the weekly Swedish documentary program Mission: Investigate broadcast an alarming episode about a scandal involving youth gender medicine at Karolinska University Hospital”— A Swedish Investigative Journalist Talks About The Youth Gender Medicine Scandal She Helped Uncover At One Of The World's Top Hospitals

“I’ve attempted to explain why previously, but here I’ll mention a couple of the most obvious reasons... Where was the editor here?”— An Emeritus Editor At Science-Based Medicine Just Sent This Letter To Steven Novella Criticizing The Site's Recent Turn Away From Rigorous Science

“Sunday night, 60 Minutes aired a 14-minute segment on youth medical transition.”— What GLAAD and the ACLU Did This Week Is Disturbing, But Unsurprising (Update)

“Thanks to a rather remarkable document just unsealed as part of Boe v. Marshall”— Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

“you already contain the genetic material to set your body down a male or female developmental pathway, even if sex differentiation doesn’t occur until later on (gonad development in utero and full sexual maturity after puberty). You can, in fact, karyotype an embryo and determine which category it fits in”— You Can’t Pseudoscience (Or Even Science) Your Way Out Of A Genuine Trans Rights Debate

“Alan Abrahamson, a respected, longtime American journalist, reported that he has seen the tests and a letter the IBA sent the IOC outlining its concerns a year ago... Khelif’s own trainer also acknowledged an issue with her chromosomes and testosterone levels”— I'm Sure Throwing J.K. Rowling In Jail Over Her Tweets Will Calm Everything Down

“Jerry Coyne... explains: ...if you do a plot of sex versus frequency... you’ll get a plot with two distinct and widely-separated peaks, with a valley containing some intermediates (intersexes and the like) between them. This is what I mean by the bimodality of sex. And there’s a reason for it: having two sexes is the result of evolution in our ancestors.”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“In a 2002 response to the 2001 Anne Fausto-Sterling paper, Leonard Sax writes: ...the true prevalence of intersex is seen to be about 0.018%, almost 100 times lower than Fausto‐Sterling's estimate of 1.7%.”— Why So Many Progressives Are Arguing That Biological Sex Doesn't Exist

“The error was likely abetted by unclear phrasing that snared me as well, albeit in a different context. (I ran this interpretation of the error by the study’s lead author and he agreed.)”— How 'Science Vs' Made Two Gender-Dysphoria Errors

“As of 2016, researchers could train a computer algorithm to distinguish male from female brains... with 93% accuracy”— (Some Of) Your July 2025 Questions, Answered

“It won’t surprise you that all three chatbots responded the same way: Yes, that’s what the author is claiming. That’s because these chatbots have basic reading comprehension!”— Two Unsurprising Updates On The Ongoing Self-Immolation Of Expert Authority

“Even a casual reader can see the projection and the hypocrisy here: Thrasher is doing exactly the thing he is falsely accusing Ryan of doing.”— On Alejandra Caraballo vs. Benjamin Ryan vs. Steven Thrasher

““Teenagers and kids should not be given the power to make these life-altering decisions that medicalization causes.” Kawaller narrated: “He thinks that the time has come to admit it was wrong to medicalize so many of these kids.””— Former GLAAD President: We Were Wrong to Medicalize Trans-Identified Children

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ID: FA-20260210-88fd60ed · Created: 2026-02-10T22:38:09.239493 · Schema v3