Gender-affirming care is deemed by proponents as a vital medical procedure for those seeking to deal with gender dysphoria, which is the mental distress of one's gender identity not matching with biological sex. Partaking in hormone replacement therapy, taking puberty blockers, or having gender-reassignment surgery to better align some of one's secondary sexual characteristics with their gender identity helps them deal with the anguish that comes with gender dysphoria. If you read from such sources as the Human Rights Campaign, ACLU, or American Medical Association, not allowing for such treatment is literally a matter of life or death.
Contrast that with what happened on the other side of the Atlantic in the United Kingdom. Britain's National Health Service (NHS) banned the use of puberty blockers to treat children dealing with gender dysphoria. This follows a June 2023 NHS report that stated "there is not enough evidence to support [puberty blockers'] safety or clinical effectiveness as a routinely available treatment." This lines up with what is currently on NHS' website as of last week:
Puberty blockers (gonadotrophin-releasing hormone analogues) are not available to children and young people for gender incongruence or gender dysphoria because there is not enough evidence of safety or clinical evidence...Long-term cross-sex hormone treatment may cause temporary or even permanent fertility.
This should not be surprising. These puberty blockers are the same drugs used to castrate sex offenders, which has some nasty side effects, including decreased bone density, deteriorating mental health, and lowered IQ. This all leads to what I illustrated last year: the evidence base is too weak to justify youth gender-affirming care.
There are European countries that have implemented these medical procedures before it became trendy in the United States, including England, Sweden, Finland, and France. They have conducted systematic reviews only to find the evidence for these practices is lacking. Rather than make it readily available like candy, the approach in these countries is to limit these procedures as a last resort and to do so in a clinical setting. These countries otherwise use psychotherapy to help children navigate gender dysphoria, which does not even consider that about four out of five adolescents who have gender dysphoria naturally overcome it by the time they are adults without these medical procedures.
Medical treatments are supposed to be backed by a growing body of well-researched evidence. Rigorous scientific consideration should be considered when discuss the physical and mental well-being of a child. The scientific process should not take a back seat simply because it does not line up with one's political beliefs or whims. I am glad to see NHS correctly acknowledge that the costs and uncertainties outweigh benefits and political wishes of those on the Far Left.
Yet in the United States, much of the political Left treats this practice as sacrosanct. As much as the Left likes accusing the Right of being anti-science, there are those on the Left have clung onto anti-science beliefs, whether it has been genetically modified foods are bad for your health, face masks and lockdowns helped stop COVID, or any body size is healthy. It is a similar adherence to faith that you see when there is climate change fear-mongering: not an iota of healthy skepticism. For these individuals, they believe without question that they are helping children. There is the misconception that to be against gender-affirming care is to either be a bigot or want trans children dead without considering the possibility that these medical procedures, much like any other medical procedure, are not without any drawbacks or side effects. The naysayers are accused of starting a culture war, even though it is the proponents who fired the first shot.
Gender-affirming care is experimental because there are no long-term studies showing its efficacy. It is also irreversible in that such procedures as mastectomies and penectomies cannot be undone. On top of it all, we are already seeing side effects with puberty blockers. Given the nature of such medical procedures, the burden of proof is on proponents to show that the benefits exceed the costs, not on naysayers to show it does not. To reiterate, I am a proponent of the Swedish approach, which is limiting these procedures and doing so in a clinical setting to develop more evidence. Any clinician pushing an experimental procedure without having the evidence to back it up is downright irresponsible. I hope that more people in the United States will start scrutinizing this medical procedure as we should scrutinize other things that could cause us considerable harm.
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