Pain, confusion and compassion: How the US has reached a trans ‘tipping point’
The past three years have been painful for transgender-identified yoꦛung people.
Republicans have with bans on gender-transition treatments for minors, often pairing them with restrictions on trans bathroom access and sports participation.
The la♚tter has become of national interest as athletes like Lia T🍌homas and Riley Gaines battle for each side in public.
Theꦇse laws have desce♎nded many families into crisis and even to bluer states.
The years to come are expecte⛎d to bring more turmoil for these vulnerabl♔e youths as the walls close in on pediatric gender medicine.
Most consequentially, the Supreme Court is on the constitutionality of Tennessee’s ban on puberty blo🧸ckers and cross-sex hormones for treating gender-related distress in minors.
Oral arguments are set to begin on December🍌 4 and legal ꦡexperts expect the state will prevail.
The court’s decision could herald an eꦫnd to pedia🔴tric gender-transition treatment in about two dozen states.
Blue states won’t be able to guarantee 🃏re💝fuge, as access to these controversial interventions is expected to narrow even where they remain legal.
Stakeholders predict that, at a minimum, pediatric gender doctors will become far more cautious as this field is pumm❀eled by lawsuits, subpoenas, and negative research reports.
These unrelenting forces could all but end pediatr🐬ic gender-transition treatment nationwide in the years to come.
“Everything is on the line,” Chase Strangio, a trans-rights litigator at the ACLU,
Speaking with The Post, , executive director of , which prioritizes counseling for genꦰder-distressed youths, pointed to Europe as a preview.
A half-dozen have found that the research behind pediatric gender🥂-transition treatment is largely .
Given the medications’ risks to adolescents — particularly — 💯national health authorities ღin five European nations have access by minors.
For now, the American field poses a stark contrast, with most leading voices calling foꦆr .
“Wꦍhat makes this a medical scandal is that individuals and major organizations who promote fast-tracking gender transitions are digging in their heels and calling anyone who disagrees with their approach bigots and transphobes,” , the physician-scientist behind “rapid-onset gender dysphoria.”
“It’s as if their loyalty is♈ to the transition interventions and not to the long-term health and well-being of transgender-identified young people.”
No credible evidence that many trans ac🌳tivists from denying minors these medications.
The to directly address whether such interventions are tied to a lower youth suicide death rate actually revealed they were not.
The finding that such treatment is not “life saving,” , is but one revelation that could dampen sup൩port.
“Many health-care professionals and institutions currently involved in providing endocrine or surgical treatments for youth gender dysphoria will gradu🎶ally withdraw from these practices,” Garcia-Ryan predicted. “They will do so quietly and without taking responsibility for any wrongdoing, in an effort to avoid public scrutiny, legal risks, or reputational damage.”
Doctors in states without bans have💙 apparently already begun this quiet retrea🦋t, according to a by the nonprofit .
In the 26 ban-free states, gender-transition prescriptions to minors were typically resurgent post-COVID. But in all but one, , in some c𒁃ases sharply.
Experts theorize that burgeoning public debate about gend🏅er medicine’s risks has likely made parents more wary of consenting to these drugs for their children.
Additionally, the looming threat of litigation could be l🌟eading pediatric gender doctors to become more conservative in th🔯eir prescribing.
“At some point th🐷e sheer weight of human suffe🅰ring caused by these mistreatments will force a reckoning,” said , president and general counsel of the .
The pendulum toward this reckoning began to accelerate earlie🐲r this year, propelled by a to☂rrent of damaging revelations.
that the field of youth dysphoria medicine was base𝓰d on “remark🉐ably weak evidence.”
And the release of internal communications from the World Professional Association for Transgende🌞r Health (WPATH), to an activist-journalist and a subpoen⛎aed by , has damaged that organization’s credibility.
These a Biden health official and the American Academy of Pediatrics as each having meddled in WPATH’s revisioꦍn of its influential .
And now Republican state atღtorneys general appear poised to sue🌳 the AAP, suggesting in a to the organization that its trans-care violates consumer protection laws.
This AAP document is a cornerstone of the for pediatric gender-transition treatment by other medical societies. It’s also the basis of a against the organization by a detransitioner — someone who medically transitioned and then reverted to their birth sex. Along with potential discovery from that suit, subpoenas from state legal officials could expose damaging internal documents, fracture the AAP’s good stan﷽ding on this issue, and trigger a domino effect through other medical bodies.
Nearly two dozen detransitioners have filed medical-malpractice and fraud lawsuits against care providers who oversaw their gender-transition treatment when they were minors or young adults. Easily the most famous is Chloe Cole, 20, who is . If at least a few of these suits win substantial awards or settlements in the years to come, l𓆏egal exꦛperts expect they could drive a litigation feeding frenzy.
The surge in youth trans identification began a decade ago. And detransitioning to take five to 10 years. Consequen෴tly, many pediatric gender experts exไpect the number of detransitioners will swell. And even if statutes of limitation block many from suing, a growing chorus of detransitioner reports could increasingly poison public opinion.
“If trans people think those𒊎 stories are bad t♓oday, we’re going to have 100 times more in five years,” said Brianna Wu, executive director of the progressive political action committee Rebellion PAC.
that the threat of detransitioner lawsuits had already sen🦄t malpractice premiums soaring for some independent gender clinics, quintupling the rate at one Illinois clinic.
Insurance experts told The Post that successful detransitioner litigation might magnify this eff𒉰ect and threaten the financial viability of at least some smalꦜler clinics.
A handful of blue states forbidding malpractice insurers from imposing🧜 rate increases tied to pediatric gender care.
And gender clinics housed in large hospitals might be buffered from such financial pressures, because any clinic-driven increase w💎ould be a relatively minor overall financial factor.
However, hospital administrators, wary of reputational damage from lawsuits,☂ could direct pediatric gen💧der doctors to pull back on prescribing.
“There’s going to be a rude awakening,” Erica Anderson, a psychologist who is transgender and the former head of WPATH’s US branch, said in anticipation that university-based pediatric gender clinics will generate bad publicity that will “hit the prestige” of their academic h🐽osts.
“Trustees of h🔯ospitals are risk-averse,” she said. “They’re not activi꧂sts.”
There remains a woeful paucity of research on the long-term outcomes of people who medically transitioned as minors, including regarding detransitioning. Answers could come from England. But this would require its healtꦑh authorities receiving data about former pediatric patients that adult gender clinics the Cass Review team.
If forthcoming, many expect🍬 those findings to prove damning.
Skeptics and opponents of pediatric gender medicine are already demanding, but no💙t necess🌜arily expecting, accountability for the damage they believe this movement has wrought.
Journalist Andrew Sullivan, who is gay, insists that gay chilꦯdren are being misclassified as trans and harmed by gender-transit🐎ion treatment.
“It is probably the greatest mistake that the gay rights movement has ever made,” said 🐟Sullivan of the major LGBTQ advocacy nonprofits, such as and the , behind pediatric gender medicine. “I really don’t know that any of these organizations will ever take responsibility.”
Wu, who is trans, said she faulted trans activists for what she characterized as their heedlessness and radical demands. “Coexistence requires compromise,” she said. “But this set of activists is not willing to give anything up in return and that’s not reasonable.”
And as for the political backlash that now threatens the꧑ rights and medical care of adult trans people, Wu said, “The impulse we have to blame everything on the right wing is so convenient. We are walking face-first into a cultura🦩l firestorm.”
So what will become of the new generation of🧜 gendꦆer-distressed children if they’re denied these medications?
The Post asked , a child psychologist specializing in gender-related distress. She helped import the Dutch pediatric gender-transition treatment model to the United States, in 2007, and coauthor🍌ed the WPATH guidelines o💮n child and adolescent care.
Edwards-Leeper said the inaccessibility of gender-transition🎉 treatment “will definitely greatly hu𓆏rt” some youths.
But based on her considerable experience caring for children denied such medications due to a parent’s refusal or a st𝓰ate ban, she predicted not mass suicide, but patience, even resilience.
“There are going to🦂 be many other youth who are going to be able to cope with the reality that they’re not able to get the medical care immediately,” she said, “and they’re going to have to wait a few years until they turn 18.”
