I am absolutely willing to be convinced on this pointt, but between the book "Blind Spots" and this article (I haven't followed any links yet, but will,) I see mostly discussion of children who have made their decisions as adolescents. What about the ones who are insistent from their earliest years? I know one child who socially transitioned around 4 and another (they don't know each other and are on opposite coasts) at 6. Are their results the same? Because the one who transitioned at 6 made an amazing change in behavior, happiness, and engagement when his parents allowed him to transition. I see him daily, as well as his twin sister, and I can't imagine him being forced back into that shell because of his bodily changes. I think lumping those children into the ones similar to the family cited in this article isn't appropriate.
Sweden and the Netherlands have toughened their screening process for hormones and puberty blockers and increased the requirements for psychological assessment, but as Hanna Barnes book details, their updated screening processes, and their followup research, leave many questions.
You seem over confident about how easy it is to assess and treat a depressed, anxious, and dysphoric child. It can take years of at least monthly appointments with psychiatrists and therapists to stabilize a depressed, autistic, anxious or self harming teenager. I'm with Dr. David Bell of the Tavistock clinic, and not with the simplistic screening process of a few visits that you suggest.
"...prestigious intuitions such as Harvard." A perfect typo.
I absolutely agree with Mr. Ryan except for his belief that there is no "medical field in which activist and advocacy goals are so consistently prioritized over dispassionate, honest and transparent science."
I’ve been thinking about how crazy it is how we practice medicine with gender dysphoria compared to the typical route of evidence based medicine. For example, cervical radiculopathy is a chronic painful condition with no clear best treatment option where sometimes surgery is a good option. It would be insane though if there were advocacy groups that said that it was a human right to get neck surgery. Physical therapists would be called bigots because they advocated for a few months of PT to determine if the patients pain could be controlled with conservative measures. If we saw a 4000% increase in young women saying that they had neck pain, it would be wild if we decided to apply the previous evidence about how adults with herniated disks sometimes improve following surgery to encourage these girls to undergo surgery. What if doctors told parents that they were bigoted if they didn’t agree with this plan and said, “people with chronic neck pain are more likely to commit suicide, therefore you should go through with a neck surgery because your daughter will kill herself if you don’t.” How about if doctors held out on publishing data on outcomes for neck surgery in neck pain because they didn’t want it to be used for political opposition. This would all be absolutely insane, but it’s what’s happening with gender medicine.
With cervical radiculopathy there are a variety of treatment options with risks and benefits, many patients will have their pain resolve with conservative measures and we consider surgery for more severe cases and when conservative measures don’t help. But even when surgery is considered, there’s discussions about when it should be considered and the risks and benefits based on the most up to date research. There’s open discussion about how effective PT, steroid injections, gabapentin and other pain control methods are. If there was innovative strategies for management, we’d see small scale research trials with people involved fully aware that what they were engaging in was experimental.
Patients with gender dysphoria deserve the same treatment as people with other conditions with many treatment options: open inquiry into options for management (including doing nothing), honest discussion about what we do and don’t know about these options, and researchers who are passionate about helping but not passionate about one specific treatment option.
I appreciate you sharing this. Endless gratitude to Ryan for his diligent work in exposing this scandal that is trying to destroy my daughter, me, and thousands of other children and parents who are shell shocked and forced into silence while we look to guide the children out safely. For some , it’s too late and permanent harm has been done to their bodies and minds….collateral damage.
It's amazing how a very small extreme group of activists are trying to shame ppl who question such serious irreversible procedures. The fact that we are talking about children should make this a very important topic of discussion. Other countries have stopped puberty blockers and surgeries on minors. This Olson-Kennedy woman needs to be held accountable for hiding information. There is $$$$ involved in all of this. These trans kids become lifelong patients. Follow the money. It's sick. Must be stopped. Keep exposing them. Thank you for posting. Sabrinalabow.substack.com
Thank you for this article & for chronicling this regrettable chapter in medical history. There may have been good intentions by those who have spread & promoted “The Dutch Protocol”, but the fact is that this has turned out to be the most poorly designed, poorly executed, largest, unethical experiment involving children ever undertaken in medicine. Those failing to have an honest conversation about this issue when faced with the information in this article, and others like it, can no longer claim plausible deniability.
The errors in gender medicine are a symptom of greater problems in society, and many more children will be harmed if we fail to course correct. In our eagerness to be supportive and avoid mistakes of the past, we have inadvertently helped create a compensatory movement.
Ethan Waters talks about the concept of SYMPTOM POOLS in which the unconscious mind looks to the language of its time to express its internal distress.
In Dr. Jonathan Hait's book: "Anxious Generation", he notes since 2010 (and the advent of smart phone use) the number of kids aged 12-17yo diagnosed with major depression in the US increased by 135% in girls and 161% in boys.
Kids need love, a proper biopsychosocial assessment & exploratory therapy. We need to return to a more measured approach…like the rest of the world is doing.
"Kids need love, a proper biopsychosocial assessment & exploratory therapy. We need to return to a more measured approach…like the rest of the world is doing."
Which rest of the world?
I think a lot of Americans like to think that things are done better in Canada, the UK, Europe, or somewhere else.
A few European countries have reversed course on puberty blockers.
In the UK, there has been a reversal on puberty blockers in the National Health Service. However, at the same time, there is a huge uptick in the use of private clinics in the UK to gain access to hormones starting at age 16.
One or two Canadian provinces have blocked the use of puberty blockers for teenagers. The rest of the country is still all in on gender transition for teens.
As to "biopsychosocial assessment & exploratory therapy", to be frank, speaking as a Canadian/American, there is almost no "biopsychosocial assessment & exploratory therapy" in Canada. The Canadian health care system is in a shambles and can barely provide routine care, let alone any kind of exploratory therapy. This is also increasingly the case with the National Health Service in the UK.
In California, unless one has top of the line health care insurance, which one would only have if they worked for a city or state government, or for a very large company, "biopsychosocial assessment & exploratory therapy" is not available for most.
One of the realities is that when teens present with anxiety or gender dysphoria, many health care practioners neither have the time or the resources, to do "biopsychosocial assessment & exploratory therapy". That is especially the case when teens, after being groomed online, are demanding instant gender transition.
Sweden, Finland, and Netherlands as of 2022 have done systematic literature reviews/ are now being more restrictive with medical treatments. Denmark has also followed suit.
Chile, Norway, France & South Africa are all beginning to re-evaluate data/ do investigations on current practices.
2023 article, “…the message emanating from European gender experts is that until there is reliable long-term evidence that the benefits of youth gender transition outweigh the risks, it is prudent to limit most medical interventions to rigorous clinical research settings.”
North America seems to be unique in its unwillingness to discuss/ engage its outsized confidence in data of poor quality on this issue.
I hope the growing number of patients who are detransitioning and desisting and speaking about it publicly will spark more questioning & thoughtful conversations.
Change will be slow. In the meantime, see resources below.
In regard to lack of time or resources for a proper assessment, I beg to differ. Although ideal would be a thorough assessment with a Psychologist or Psychiatrist (I grant you this is difficult to access), ANY medical clinician (especially one PRESCRIBING medication of any kind) should take a medical, family, and social history — which covers a large portion of the same type of information. A GAD-7 (anxiety screen) and PHQ-9 (depression screen) can be administered in a few minutes followed by some clarifying questions & appropriate labs to screen for underlying issues. That is a place ANY clinician (in primary care, endocrinology or mental health clinics, for example) should start when a distressed patient presents & it can be done over several visits. This is not a new / complicated approach. What IS new, is accepting a diagnosis a patient tells you they have without doing any history taking or evaluation of your own (as a physician or APP).
Parents can ask for this type of approach if it’s not being done.
There are also a growing number of resources for patients, parents, physicians/other clinicians who recognize the need for a more holistic approach to care for these kids:
1)Genspect (International) offers many resources for a more scientific & thoughtful approach:
Sweden and the Netherlands have toughened their screening process for hormones and puberty blockers and increased the requirements for psychological assessment, but as Hanna Barnes book details, their updated screening processes, and their followup research, leave many questions.
You seem over confident about how easy it is to assess and treat a depressed, anxious, and dysphoric child. It can take years of at least monthly appointments with psychiatrists and therapists to stabilize a depressed, autistic, anxious or self harming teenager. I'm with Dr. David Bell of the Tavistock clinic, and not with the simplistic screening process of a few visits that you suggest.
Your list of resources is helpful. I'm aware of many of the substacks you mention. But for a deep dive on what is going on with gender dysphoric teens, i suggest Eliza Mondegreen's substack gender:hacked and Jean M. Twenge's substack Generation Tech.
I didn’t mean to imply other countries have this all figured out. I was just (inarticulately) expressing my frustration with the United State’s (broad) unwillingness to acknowledge that it’s “Time to Think”, as Hanna Barnes’ book suggests, compared to other countries.
I also did not mean to suggest that it is easy to assess & treat an adolescent in distress. I simply meant that any of the physicians/APPs who are writing prescriptions for adolescents are capable of first STARTING with a basic “exploratory” approach—which does not require the level of screening tools used by Neuropsychologists, at least to begin with. It requires the clinician to approach the patient as if they came in with abdominal pain or a headache —as a diagnostic challenge. I wish more of us (in medicine & mental health) would remember that.
Unless an adolescent is actively suicidal, one does not need to be a specialist or be in a specialty clinic to START the process of establishing rapport with active listening, providing a confidential space & continuity, obtaining a proper history and initiating a work up to try to find the cause of symptoms. In my experience, when a patient knows someone cares about them & that they are being listened to, that in and of itself can be very therapeutic and provide stability (a life raft of sorts) long before a specialist is involved. I absolutely believe in long term patient relationships & continuity of care. When I said the process could be done over several visits, I was trying to speak to clinicians who would argue that they would not be able to complete an assessment in one 15 minute time slot (as some clinics use). It’s OK to admit we don’t yet know the diagnosis & just start SOMEWHERE with short frequent visits. A first “intervention”, for example, could be as simple as an agreement to limit screen time to 2 hours a day outside of school (knowing this will not be satisfying to the teen demanding transition, but indicating, “I care about you, and I want to make sure we get this right; this will take time”).
Thank you for those resources. I know many of us (in medicine/mental health) are woefully ignorant as to what is actually going on with this population of patients (just as we were when the opioid epidemic first began to hit).
I absolutely agree with you that it is within the capacity of the current system in the US to do better initial assessments. Thank you for posting this information.
You seem very knowledgeable, so I hope you keep trying to get the word out about better initial assessments rather than immediate affirmation for teens presenting with gender dysphoria.
So you know that I am not just passively commenting away here on substack, I actually wrote to my San Francisco supervisor (Rafael Mandelman) in 2022 about this very issue. (Mandelman is a close friend of state senator Scott Wiener.) I expressed my concern that initial assessments and longer term care for gender dysphoric teens didn't seem to be happening in California. His response: "I support the trans movement and I do not support transphobia." In effect, he accused me of being a transphobe for expressing concern about the screening process and psychological care available for teens expressing gender dysphoria.
So it is not by accident that better screening is not available in California.
It’s really unfortunate an official would take such an approach & it dismays me that people have trouble thinking deeply about this. Good for you for trying to enact change.
It's also important to note that the NYT catches and exposed Olsen-Kennedy falsely stating that the reason the puberty blockers didn't improve the mental health in the study subjects is because they all had such good mental health to start with when, in fact, it had been stated in a published 2022 paper that 1/4 were seriously depressed or suicidal. Given this exposed attempt at deception, the many other examples of researchers manipulating, misrepresenting, and hiding negative or unflattering results, plus the blatant and extreme bullying behavior of activists, it must be considered that the body of research cited by the multiple systematic reviews isn't just "weak or inconclusive," but potentially fraudulent.
Bravo to those who boycott the AAP and other organizations that sanction "gender medical" practices on children. Of course, the NIH and other government agencies that fund and encourage this sort of thing should be abolished. Public (tax supported) education is also complicit in encouraging children to question their gender identification and should be eliminated as well. Those who think that putting the right people in charge are naive and will continue to be disappointed. It is the institutions that must be eliminated.
Thank you for covering this important topic. I have been in entrenched in this living hell (that is what it is) for years after a barely adult daughter was sucked into the trans cult in college. Many years later, with scars to prove it, she has re-entered our lives as herself. There is no shortage of evil to write about. My latest piece exposing some of this evil is here: https://margox.substack.com/p/a-queer-radical-leather-witch?r=1kuq0
I cannot fathom executing these procedures on a child, let alone someone as young as my daughter. Here is to more courage!
In my entire career of practicing medicine, I have not seen anything like this. Have never seen doctors abandon their primal code of "do no harm".
And this is not physicians responding to pressure from advocacy groups. A large percentage of doctors seem to truly buy into this. They abandon all need for any data and really, abandon common sense.
I am a member of several online physician groups and the discussions that happen there are very divided - more so in favor of this transgender philosophy (though anyone opposed likely just not able to speak up). If you ask for data or evidence that these hormone treatments or surgeries are beneficial and safe, a mob-like pile on occurs - vicious and angry. You will be called a bigot. The truly frightening aspect is when they do produce some "data", they link to a "study" that consists of a review of observational studies, referencing small reports done on transgender individuals from the 1990s (almost all male to female in their 30s - completely irrelevant to the population we are talking about today). It shocks me that any physician would call that "data".
So there is no medical debate or discussion. It functions on zealous personal philosophy that does not allow questioning.
As a physician, I want to be on record that this is a travesty and an assault on children. We are using drugs we have no data on long term effects; we're doing irreversible surgeries. This mind set functions as a religion or cult - no questioning allowed. This is definitely not "science".
There have been changes in Europe where they have started to pull back on this. I am hoping we have some change here.
Strongly suggest that you read Hannah Barnes book "Time to Think". Make sure you get the version that was published in July of 2024. The Audible version of this book is also great.
I am absolutely willing to be convinced on this pointt, but between the book "Blind Spots" and this article (I haven't followed any links yet, but will,) I see mostly discussion of children who have made their decisions as adolescents. What about the ones who are insistent from their earliest years? I know one child who socially transitioned around 4 and another (they don't know each other and are on opposite coasts) at 6. Are their results the same? Because the one who transitioned at 6 made an amazing change in behavior, happiness, and engagement when his parents allowed him to transition. I see him daily, as well as his twin sister, and I can't imagine him being forced back into that shell because of his bodily changes. I think lumping those children into the ones similar to the family cited in this article isn't appropriate.
Thank you, Benjamin, for your integrity and courage. We must keep asking for data, the best data available, and not poor quality studies.
Sweden and the Netherlands have toughened their screening process for hormones and puberty blockers and increased the requirements for psychological assessment, but as Hanna Barnes book details, their updated screening processes, and their followup research, leave many questions.
You seem over confident about how easy it is to assess and treat a depressed, anxious, and dysphoric child. It can take years of at least monthly appointments with psychiatrists and therapists to stabilize a depressed, autistic, anxious or self harming teenager. I'm with Dr. David Bell of the Tavistock clinic, and not with the simplistic screening process of a few visits that you suggest.
I agree with Mr. Ryan, I think this course of medical intervention may end up being the equivalent of the Tuskegee Syphilis Study for this generation.
Yes; exactly. What a hellish nightmare and our children are suffering from a lack of adults in the room.
"...prestigious intuitions such as Harvard." A perfect typo.
I absolutely agree with Mr. Ryan except for his belief that there is no "medical field in which activist and advocacy goals are so consistently prioritized over dispassionate, honest and transparent science."
The abortion debate set the trend.
I’ve been thinking about how crazy it is how we practice medicine with gender dysphoria compared to the typical route of evidence based medicine. For example, cervical radiculopathy is a chronic painful condition with no clear best treatment option where sometimes surgery is a good option. It would be insane though if there were advocacy groups that said that it was a human right to get neck surgery. Physical therapists would be called bigots because they advocated for a few months of PT to determine if the patients pain could be controlled with conservative measures. If we saw a 4000% increase in young women saying that they had neck pain, it would be wild if we decided to apply the previous evidence about how adults with herniated disks sometimes improve following surgery to encourage these girls to undergo surgery. What if doctors told parents that they were bigoted if they didn’t agree with this plan and said, “people with chronic neck pain are more likely to commit suicide, therefore you should go through with a neck surgery because your daughter will kill herself if you don’t.” How about if doctors held out on publishing data on outcomes for neck surgery in neck pain because they didn’t want it to be used for political opposition. This would all be absolutely insane, but it’s what’s happening with gender medicine.
With cervical radiculopathy there are a variety of treatment options with risks and benefits, many patients will have their pain resolve with conservative measures and we consider surgery for more severe cases and when conservative measures don’t help. But even when surgery is considered, there’s discussions about when it should be considered and the risks and benefits based on the most up to date research. There’s open discussion about how effective PT, steroid injections, gabapentin and other pain control methods are. If there was innovative strategies for management, we’d see small scale research trials with people involved fully aware that what they were engaging in was experimental.
Patients with gender dysphoria deserve the same treatment as people with other conditions with many treatment options: open inquiry into options for management (including doing nothing), honest discussion about what we do and don’t know about these options, and researchers who are passionate about helping but not passionate about one specific treatment option.
"with the best of intentions" I am dubious.
I appreciate you sharing this. Endless gratitude to Ryan for his diligent work in exposing this scandal that is trying to destroy my daughter, me, and thousands of other children and parents who are shell shocked and forced into silence while we look to guide the children out safely. For some , it’s too late and permanent harm has been done to their bodies and minds….collateral damage.
It's amazing how a very small extreme group of activists are trying to shame ppl who question such serious irreversible procedures. The fact that we are talking about children should make this a very important topic of discussion. Other countries have stopped puberty blockers and surgeries on minors. This Olson-Kennedy woman needs to be held accountable for hiding information. There is $$$$ involved in all of this. These trans kids become lifelong patients. Follow the money. It's sick. Must be stopped. Keep exposing them. Thank you for posting. Sabrinalabow.substack.com
Thank you for this article & for chronicling this regrettable chapter in medical history. There may have been good intentions by those who have spread & promoted “The Dutch Protocol”, but the fact is that this has turned out to be the most poorly designed, poorly executed, largest, unethical experiment involving children ever undertaken in medicine. Those failing to have an honest conversation about this issue when faced with the information in this article, and others like it, can no longer claim plausible deniability.
The errors in gender medicine are a symptom of greater problems in society, and many more children will be harmed if we fail to course correct. In our eagerness to be supportive and avoid mistakes of the past, we have inadvertently helped create a compensatory movement.
Ethan Waters talks about the concept of SYMPTOM POOLS in which the unconscious mind looks to the language of its time to express its internal distress.
In Dr. Jonathan Hait's book: "Anxious Generation", he notes since 2010 (and the advent of smart phone use) the number of kids aged 12-17yo diagnosed with major depression in the US increased by 135% in girls and 161% in boys.
Kids need love, a proper biopsychosocial assessment & exploratory therapy. We need to return to a more measured approach…like the rest of the world is doing.
Highly recommend works by Jonathan Haidt, PhD, author of The Anxious Generation and The Coddling of the American Mind.
"Kids need love, a proper biopsychosocial assessment & exploratory therapy. We need to return to a more measured approach…like the rest of the world is doing."
Which rest of the world?
I think a lot of Americans like to think that things are done better in Canada, the UK, Europe, or somewhere else.
A few European countries have reversed course on puberty blockers.
In the UK, there has been a reversal on puberty blockers in the National Health Service. However, at the same time, there is a huge uptick in the use of private clinics in the UK to gain access to hormones starting at age 16.
One or two Canadian provinces have blocked the use of puberty blockers for teenagers. The rest of the country is still all in on gender transition for teens.
As to "biopsychosocial assessment & exploratory therapy", to be frank, speaking as a Canadian/American, there is almost no "biopsychosocial assessment & exploratory therapy" in Canada. The Canadian health care system is in a shambles and can barely provide routine care, let alone any kind of exploratory therapy. This is also increasingly the case with the National Health Service in the UK.
In California, unless one has top of the line health care insurance, which one would only have if they worked for a city or state government, or for a very large company, "biopsychosocial assessment & exploratory therapy" is not available for most.
One of the realities is that when teens present with anxiety or gender dysphoria, many health care practioners neither have the time or the resources, to do "biopsychosocial assessment & exploratory therapy". That is especially the case when teens, after being groomed online, are demanding instant gender transition.
Sweden, Finland, and Netherlands as of 2022 have done systematic literature reviews/ are now being more restrictive with medical treatments. Denmark has also followed suit.
Chile, Norway, France & South Africa are all beginning to re-evaluate data/ do investigations on current practices.
2023 article, “…the message emanating from European gender experts is that until there is reliable long-term evidence that the benefits of youth gender transition outweigh the risks, it is prudent to limit most medical interventions to rigorous clinical research settings.”
North America seems to be unique in its unwillingness to discuss/ engage its outsized confidence in data of poor quality on this issue.
I hope the growing number of patients who are detransitioning and desisting and speaking about it publicly will spark more questioning & thoughtful conversations.
Change will be slow. In the meantime, see resources below.
In regard to lack of time or resources for a proper assessment, I beg to differ. Although ideal would be a thorough assessment with a Psychologist or Psychiatrist (I grant you this is difficult to access), ANY medical clinician (especially one PRESCRIBING medication of any kind) should take a medical, family, and social history — which covers a large portion of the same type of information. A GAD-7 (anxiety screen) and PHQ-9 (depression screen) can be administered in a few minutes followed by some clarifying questions & appropriate labs to screen for underlying issues. That is a place ANY clinician (in primary care, endocrinology or mental health clinics, for example) should start when a distressed patient presents & it can be done over several visits. This is not a new / complicated approach. What IS new, is accepting a diagnosis a patient tells you they have without doing any history taking or evaluation of your own (as a physician or APP).
Parents can ask for this type of approach if it’s not being done.
There are also a growing number of resources for patients, parents, physicians/other clinicians who recognize the need for a more holistic approach to care for these kids:
1)Genspect (International) offers many resources for a more scientific & thoughtful approach:
-The Killarney Group, a think tank that is developing a Gender Framework. Here is an article outlining the project: https://www.realityslaststand.com/p/the-end-of-wpath-introducing-the
-Gender Exploratory Therapy Association (GETA)
They have free resources online including guidance for parents, therapists & clinicians
https://www.therapyfirst.org/
2)LGBT courage Coalition (US & Canada) https://www.lgbtcourage.org/
3)Gender Dysphoria Alliance (Canada) https://www.genderdysphoriaalliance.com/
4)Inspired Teen Therapy
https://sashaayad.com/
5)Stella O’Malley
http://www.stellaomalley.com/
6)Detrans count
https://detranscount.wixsite.com/website
7)Detrans Foundation
https://www.detransfoundation.com/
Sweden and the Netherlands have toughened their screening process for hormones and puberty blockers and increased the requirements for psychological assessment, but as Hanna Barnes book details, their updated screening processes, and their followup research, leave many questions.
You seem over confident about how easy it is to assess and treat a depressed, anxious, and dysphoric child. It can take years of at least monthly appointments with psychiatrists and therapists to stabilize a depressed, autistic, anxious or self harming teenager. I'm with Dr. David Bell of the Tavistock clinic, and not with the simplistic screening process of a few visits that you suggest.
Your list of resources is helpful. I'm aware of many of the substacks you mention. But for a deep dive on what is going on with gender dysphoric teens, i suggest Eliza Mondegreen's substack gender:hacked and Jean M. Twenge's substack Generation Tech.
I didn’t mean to imply other countries have this all figured out. I was just (inarticulately) expressing my frustration with the United State’s (broad) unwillingness to acknowledge that it’s “Time to Think”, as Hanna Barnes’ book suggests, compared to other countries.
I also did not mean to suggest that it is easy to assess & treat an adolescent in distress. I simply meant that any of the physicians/APPs who are writing prescriptions for adolescents are capable of first STARTING with a basic “exploratory” approach—which does not require the level of screening tools used by Neuropsychologists, at least to begin with. It requires the clinician to approach the patient as if they came in with abdominal pain or a headache —as a diagnostic challenge. I wish more of us (in medicine & mental health) would remember that.
https://www.annfammed.org/content/annalsfm/16/4/353.full.pdf
Unless an adolescent is actively suicidal, one does not need to be a specialist or be in a specialty clinic to START the process of establishing rapport with active listening, providing a confidential space & continuity, obtaining a proper history and initiating a work up to try to find the cause of symptoms. In my experience, when a patient knows someone cares about them & that they are being listened to, that in and of itself can be very therapeutic and provide stability (a life raft of sorts) long before a specialist is involved. I absolutely believe in long term patient relationships & continuity of care. When I said the process could be done over several visits, I was trying to speak to clinicians who would argue that they would not be able to complete an assessment in one 15 minute time slot (as some clinics use). It’s OK to admit we don’t yet know the diagnosis & just start SOMEWHERE with short frequent visits. A first “intervention”, for example, could be as simple as an agreement to limit screen time to 2 hours a day outside of school (knowing this will not be satisfying to the teen demanding transition, but indicating, “I care about you, and I want to make sure we get this right; this will take time”).
Thank you for those resources. I know many of us (in medicine/mental health) are woefully ignorant as to what is actually going on with this population of patients (just as we were when the opioid epidemic first began to hit).
I absolutely agree with you that it is within the capacity of the current system in the US to do better initial assessments. Thank you for posting this information.
You seem very knowledgeable, so I hope you keep trying to get the word out about better initial assessments rather than immediate affirmation for teens presenting with gender dysphoria.
So you know that I am not just passively commenting away here on substack, I actually wrote to my San Francisco supervisor (Rafael Mandelman) in 2022 about this very issue. (Mandelman is a close friend of state senator Scott Wiener.) I expressed my concern that initial assessments and longer term care for gender dysphoric teens didn't seem to be happening in California. His response: "I support the trans movement and I do not support transphobia." In effect, he accused me of being a transphobe for expressing concern about the screening process and psychological care available for teens expressing gender dysphoria.
So it is not by accident that better screening is not available in California.
It’s really unfortunate an official would take such an approach & it dismays me that people have trouble thinking deeply about this. Good for you for trying to enact change.
It's also important to note that the NYT catches and exposed Olsen-Kennedy falsely stating that the reason the puberty blockers didn't improve the mental health in the study subjects is because they all had such good mental health to start with when, in fact, it had been stated in a published 2022 paper that 1/4 were seriously depressed or suicidal. Given this exposed attempt at deception, the many other examples of researchers manipulating, misrepresenting, and hiding negative or unflattering results, plus the blatant and extreme bullying behavior of activists, it must be considered that the body of research cited by the multiple systematic reviews isn't just "weak or inconclusive," but potentially fraudulent.
It's shocking what we have allowed to happen to children. It's hard to have any trust at all in our medical establishment.
These “doctors” and “researchers” lack basic medical ethics and their actions are beyond the pale.
Their behaviour is a stain and an embarrassment to the profession and to the broader field of science.
Bravo to those who boycott the AAP and other organizations that sanction "gender medical" practices on children. Of course, the NIH and other government agencies that fund and encourage this sort of thing should be abolished. Public (tax supported) education is also complicit in encouraging children to question their gender identification and should be eliminated as well. Those who think that putting the right people in charge are naive and will continue to be disappointed. It is the institutions that must be eliminated.
Thank you for covering this important topic. I have been in entrenched in this living hell (that is what it is) for years after a barely adult daughter was sucked into the trans cult in college. Many years later, with scars to prove it, she has re-entered our lives as herself. There is no shortage of evil to write about. My latest piece exposing some of this evil is here: https://margox.substack.com/p/a-queer-radical-leather-witch?r=1kuq0
I cannot fathom executing these procedures on a child, let alone someone as young as my daughter. Here is to more courage!
Thank you for this.
In my entire career of practicing medicine, I have not seen anything like this. Have never seen doctors abandon their primal code of "do no harm".
And this is not physicians responding to pressure from advocacy groups. A large percentage of doctors seem to truly buy into this. They abandon all need for any data and really, abandon common sense.
I am a member of several online physician groups and the discussions that happen there are very divided - more so in favor of this transgender philosophy (though anyone opposed likely just not able to speak up). If you ask for data or evidence that these hormone treatments or surgeries are beneficial and safe, a mob-like pile on occurs - vicious and angry. You will be called a bigot. The truly frightening aspect is when they do produce some "data", they link to a "study" that consists of a review of observational studies, referencing small reports done on transgender individuals from the 1990s (almost all male to female in their 30s - completely irrelevant to the population we are talking about today). It shocks me that any physician would call that "data".
So there is no medical debate or discussion. It functions on zealous personal philosophy that does not allow questioning.
As a physician, I want to be on record that this is a travesty and an assault on children. We are using drugs we have no data on long term effects; we're doing irreversible surgeries. This mind set functions as a religion or cult - no questioning allowed. This is definitely not "science".
There have been changes in Europe where they have started to pull back on this. I am hoping we have some change here.
Strongly suggest that you read Hannah Barnes book "Time to Think". Make sure you get the version that was published in July of 2024. The Audible version of this book is also great.