The shaky foundation of childhood gender transition

Photo credit: Gomina

Dr. J. Edward Les, Epoch Times, March 16, 2024

The debate around childhood “gender transition” has become so toxic as to render calm and rational discussion nearly impossible. Each side is quick to smear their opponents as malevolent or ignorant—or both.

It’s easy to lose sight of the fact that most of us simply want what’s best for our kids. It’s high time we reverted to that principle as our guiding star, particularly in the immediate aftermath of the explosive “WPATH Files.“ These leaked files shine a bright light on the troubling quality of the “Standards of Care” issued by the World Professional Association for Transgender Health (WPATH) and the questionable—and often outright lack of—science underpinning those “standards.”

Reading through a report by Environmental Progress on the files, an Ernest Hemingway quote comes to mind: “All things truly wicked start from innocence.”

The report references an excellent 2023 review by Abbruzzese et al. (“The Myth of Reliable Research in Pediatric Gender Medicine”) describing Dutch researchers in the late 1980s and early 1990s as among the first to champion the “innovative practice” of pediatric sex-trait modification. They weren’t motivated by malevolence but were genuinely looking to improve the lot of transgendered adults suffering from the disconnect between their physical bodies and their gender identity. (Historically, gender identity disorder is a real, but rare, affliction.)

Their motivations were innocent enough—laudable, even. But their analysis was shot through with methodological errors and has since been thoroughly discredited.

Yet as Abbruzzese et al. detail in their paper, the Dutch experiment “escaped the lab”; the small, flawed study diffused rapidly through the international medical community as justification for puberty suppression of gender-confused children as a prelude to cross-sex hormones and surgical modification. And despite the lack of proper evidence, those practices were adopted by WPATH as the “standard of care.”

That, coupled with the social-media-enabled explosion in adolescents identifying as transgender in the mid-2010s, led directly to where we are today: science replaced by full-blown ideology.

Jurisdictions like the UK, Norway, Sweden, Finland, and France have belatedly realized the harm caused by these experimental practices and have begun severely curtailing their use. Britain just announced a ban on puberty blockers for minors under 18, outside of regulated clinical trials. Yet Canada and the United States remain laggards.

The release of the WPATH Files—a collection of messages from an internal WPATH chat system, along with a video of an internal panel discussion—should change that. It’s clear, as whistleblower Jamie Reed put it recently, that transgender clinicians have been “building the plane while flying it.”

In the files, Dr. Daniel Metzger, a pediatric endocrinologist in B.C. and a co-author of the Canadian Paediatric Society’s position statement on gender-affirming care for youth in Canada, openly admits that gender clinicians are “often explaining these sorts of things to people who haven’t even had biology in high school yet,” and “most of the kids are nowhere in any kind of a brain space to really, really, really talk about it in a serious way.”

Fellow WPATH member and child psychologist Dr. Dianne Berg, co-author of the child chapter of WPATH’s “Standards of Care,” confesses that for children and adolescents it’s “out of their developmental range to understand the extent to which some of these medical interventions are impacting them.” And worse, even parents aren’t sufficiently health-literate to comprehend the effects of treatment protocols proposed for their gender-confused children.

Per Dr. Berg: “What really disturbs me is when the parents can’t tell me what they need to know about a medical intervention that apparently they signed off for. … [This is] not what we need to be doing ethically.”

Yet a lack of ethics is on full display. Gender transition of children with coexisting autism, developmental delay, or other mental health challenges is openly encouraged. Fertility concerns are downplayed or dismissed. The long-term harms of puberty blockers, cross-sex hormones, and irreversible surgeries are shunted aside.

WPATH has been long considered the leading authority on the care and treatment of individuals with gender dysphoria, and is frequently cited by organizations like the American Medical Association, the American Academy of Pediatrics, the Endocrine Society, and the Canadian Pediatric Society as the basis for their policies of “gender affirming care.” WPATH, in turn, points to these organizations as lending credence to their own Standards of Care.

It’s the very definition of circular reasoning.

Except that in this case it’s a circular firing squad—and it’s kids who are taking the bullets. If that isn’t wicked, I don’t know what it is.

Dr. J. Edward Les, M.D., is a pediatrician in Calgary and a senior fellow at the Aristotle Foundation for Public Policy. Permission is granted to reproduce or re-publish this column only in full and with attribution to the Aristotle Foundation for Public Policy.

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