The U.S. is the most permissive country for child access to gender transition services, according to a study that finds European countries are renewing an emphasis on therapy and resorting to physical treatment only in exceptional circumstances.
An organization known as Do No Harm analyzed laws in the U.S. and European countries and found that American youths have broader access to gender clinics, puberty blockers, cross-sex hormones and surgeries. Rules vary from state to state.
The U.S. has more than 60 pediatric gender clinics and 300 clinics that provide hormonal interventions to minors. Ireland and Norway limit assessments and treatment to one hospital, and Belgium and Finland have confined those services to two sites, the report said.
The report questions the U.S. push toward “gender affirmation,” which “assumes that gender incongruence can manifest as early as age 4 and that questioning a minor’s gender self-definition is harmful and unethical.”
President Biden has embraced gender transition procedures while red states crack down on puberty blockers, hormone treatments and sex reassignment surgeries for minors.
“I don’t think any state or anybody should have the right to do that as a moral question. As a legal question, I just think it’s wrong,” Mr. Biden said in October in a widely circulated interview with NowThis News.
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The British National Health Service announced last year that it was shutting down its leading youth gender clinic and reorganizing gender care for adolescents. It was a response to a formal review that uncovered complaints about the services and concerns about the surge of patients.
The national health service of Sweden determined last year that gender-related medical care should be administered only in “exceptional” cases, signaling greater caution in treating gender dysphoria.
“Northern and Western Europe, which share the United States’ broad support for transgenderism, reject the gender-affirming care model for children,” the report stated. “In fact, several countries, including the United Kingdom, Sweden, and Finland, have explicitly abandoned it in recent years in part due to fear that medical intervention has become overprescribed. In a sharp departure from the gender affirmation model employed in the United States, these countries now discourage automatic deference to a child’s self-declarations on the grounds that the risks outweigh the benefits, while also calling for months-long psychotherapy sessions to address co-occurring mental health problems.”
The prevalence of medical services for gender transitions has become a political flashpoint, and Republican leaders in some states are cracking down.
Texas Attorney General Ken Paxton issued a formal opinion that said certain sex change procedures amount to child abuse.
Florida Gov. Ron DeSantis last year moved to ban gender transition procedures using hormones and surgeries for transgender youths and to prohibit Medicaid insurance coverage for gender dysphoria treatments.
Mr. Biden responded to state restrictions by signing an executive order in June that directed the Justice Department to file statements of support for those challenging the restrictions in court. He directed the Department of Veterans Affairs to remove its ban on comprehensive gender transition care for transgender veterans.
Some fights are playing out between medical institutions and state leaders.
Officials at Vanderbilt University Medical Center in Tennessee announced in October that they would pause gender transitioning surgeries for minors after Republican leaders raised concerns about a video of a doctor describing the procedures as “huge moneymakers.”
VUMC officials told lawmakers that they would pause the surgeries for anyone younger than 18.
Do No Harm describes itself as a diverse group of doctors, patients and medical professionals who want to “protect health care from a radical, divisive, and discriminatory ideology.”
Its study emphasizes countries that are rethinking gender transition procedures or hormone treatments. It points to Finland, which in 2020 issued guidelines that say psychotherapy, rather than puberty blockers and cross-sex hormones, should be the first-line treatment for youths experiencing gender dysphoria.
The French National Academy of Medicine said “great medical caution should be taken in children and adolescents, given the vulnerability, particularly psychological, of this population and the many undesirable effects and even serious complications that can be caused by some of the therapies available.”
Authors of the report say they are worried that the more permissive attitude toward gender transition care will be self-reinforcing partly because of “social contagion.” It noted that the number of children known to be on puberty blockers or cross-sex hormones more than doubled from 2017 to 2021.
“Our policy review reveals the United States is the most permissive country when it comes to the legal and medical gender transition of children,” the report said. “Only France comes close, yet unlike the U.S., France’s medical authorities have recognized the uncertainties involved in transgender medical care for children and have urged ‘great caution’ in its use.”
Terry Schilling, president of the American Principles Project, said the report shows the U.S. is a “radical outlier in the western world when it comes to pushing kids towards transgender medical procedures.”
“There’s no mistaking it now: our medical industry and government authorities care more about ideology and profit than they do about the health and well-being of our kids. Hopefully, the looming cascade of malpractice lawsuits will finally convince them to return to sanity as Europe is now doing,” Mr. Schilling said. “Lawmakers in Congress and the states also need to start getting involved. For the sake of America’s families, it’s time to put a stop to this horrific experimentation.”
