“Gender-Affirming Care for Children and Adolescents”: A Euphemism for Lifelong Profiteering?

This is not science or medicine, but magical thinking writ large

Medscape is a website that advertises itself as: “the leading online global destination for physicians and healthcare professionals worldwide, offering the latest medical news and expert perspectives; essential point-of-care drug and disease information; and relevant professional education and CME.”

So, imagine my dismay when I read this article, published on 9 July 2024, entitled Gender-Affirming Care for Children and Adolescents by Dr K. Ashley Brandt, who is an OB/GYN surgeon practicing in Pennsylvania.

Dr K. Ashley Brandt

I find it especially egregious that a doctor who chose to specialize in women’s health would believe that chopping off healthy bits of people would improve their mental health. I wonder if she refers girls with anorexia to a colleague who does bariatric sleeves? I mean these starving girls identify as fat and children and adolescents all “know themselves” or so we are told.

The first error - referring to the expertise of WPATH

She writes: “When the World Professional Association for Transgender Health (WPATH) released its updated Standards of Care, SOC8, one of the noticeable changes to the document was its approach to caring for transgender children and adolescents.”

Unfortunately, Brandt doesn’t elaborate to point out that the main “change” was the total removal of lower age limits for surgically removing healthy body parts from teenagers. Or mention that these were removed at the behest of a man with AGP who holds a prominent position in the government of the USA.

Brandt is at pains to define her terms so that no one will think that anyone is doing any “gender affirming” surgeries on children, but once you learn that medically speaking “A child is an individual between the stages of infancy and puberty”, it becomes clear that while she may be technically correct, most parents would not view their 13 year old offspring as ‘non-children’ when they are talking about life changing decisions.

And this chart from an article in JAMA gives the lie to Brandt’s statement that “surgeons are not performing gender-affirming surgeries on children. On adolescents, rarely.”

JAMA Netw Open 2023; 6(8):e2330348. doi: 10.1001/jamaopennetwork.2023.30348

She also doesn’t bother to point out that the reason for not operating on girl children is that prior to the commencement of puberty, there is no breast tissue to remove and that many boys who adopt a trans identity never have their penis removed.

“Social transitioning” is an iatrogenic intervention

“According to the updated SOC8, the only acceptable gender-affirming intervention for children is psychosocial support. This does not include puberty blockers, hormones, or surgery, but rather allowing a child to explore their gender identity by experimenting with different clothing, toys, hairstyles, and even an alternative name that aligns more closely with their gender identity.”

WPATH makes no mention of the risks of social transitioning for children. Allowing children to socially transition just cements in confused thinking and confirms that delusional beliefs about being “born in the wrong body” may be true.

According to the BMJ, “Social transition is also seen as a significant intervention which may alter the course of gender development with medical and surgical interventions being sought by children whose gender dysphoria/incongruence might not have otherwise persisted beyond puberty.”

Why can’t children experiment with their “clothing, toys and hairstyles” while remaining content with the bodies they have? Why are adults enforcing such a rigid code of gendered behavior that children are made to feel their bodies are somehow defective? Where in the WPATH standards is any sort of warning about the dangers to children from parents using their “trans” child to gain social prestige?

There is no kindness in lying to children. We are not talking about Santa here, but about allowing (or in many cases, encouraging and celebrating) children to make decisions they lack the capacity to make. No preadolescent can envision an adult life without pleasurable sex, an inability to reproduce or dealing with lifelong pain and a permanently dysfunctional body, which is the inevitable result of hopping on the gender woo express and riding it to the last station.

Lies, untruths and fiction as fact

This article states that, “These medications are reversible, and their purpose is to temporarily pause puberty to allow the adolescent to further explore their gender identity.” and “The most significant side effect of puberty blockers is decreased bone density.”

There is no such thing as a paused puberty (with the rare exception of the recognized medical condition of precocious puberty). Puberty is a time sensitive step on the road to adulthood in human beings. As the Cass Review makes abundantly clear, the effects of these medications are not entirely “reversible”; their effects can linger for a lifetime, and they are a known onramp to cross sex hormones and mutilating surgeries.

And while I am concerned about teenagers having compression fractures resulting from inappropriate use of hormones, my main reservation is around what halting puberty does to brain maturation. I have written about this here.

Time Critical Brain Development

“Contrary to the current political narrative, gender-affirming care for children and adolescents is not taken lightly.” This statement is ironically hilarious as a statement of untruth. Go to Google and you can quickly find testimony after testimony from young adults talking about the ease with which they obtained puberty blockers from their own doctors, from unknown doctors and even over the internet without any sort of mental health examination at all. Rather than “years of multidisciplinary assessments”, most patients have the most cursory assessments in the history of medicine before their depression, anxiety or unexplored trauma is explained away with those magic words ‘you must be trans’.

So much education, so little understanding

In the standard author disclosure, Dr Brandt claimed no relevant financial relationships.

According to this financial report, in 2023 the sex reassignment surgery market size was worth US$3.20 billion, projected to increase to US$6.92 by 2030. Someone is clearly making out like a bandit, as the saying goes.

Brandt quotes the WPATH Standards of Care 8 with all the qualifications that are expected of those who provide “gender affirming” care. All that education must give its proponents a lot of letters behind their names. Pity that it doesn’t seem to impart any wisdom or ethical concerns around the impossibility of fixing something that ain’t broken. There is no such thing as a “trans child” and there are no other mental health conditions that are sorted out by amputating healthy pieces of our bodies and taking drugs that are known to cause harm.