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An explosive report that exposes the “transition” from evidence-based medicine and holistic care to activism and human rights discourse in the care of children with gender dysphoria was released this past week. It also highlights how Australia’s current gender care guidelines continue to ignore developments in other countries where the use of puberty blockers on children is prohibited, and how bans on so-called conversion therapy are restricting the ability of doctors to provide optimal care to their young patients. 

The report made the front page of The Australian newspaper but was otherwise not picked up by any other mainstream outlet. I think it should have been front-page news everywhere. 

Published in the Human Systems journal, the report compares and contrasts the approach to the care of children and adolescents in gender clinics across Australia, the UK, Spain, and the USA. It is authored by medical practitioners who practise in areas of child and adolescent health in five different countries. 

The report explains that, even as recently as 20 years ago, the treatment of gender dysphoria in adults and children was quite conservative because there was no evidence-based research to support the treatments being proposed.  

“To mitigate risk and to implement safeguards, most countries initially established multidisciplinary teams that conducted comprehensive assessments—including screening of patients to ensure that they met diagnostic eligibility criteria—and that implemented treatment using a bio-psychosocial (holistic) approach,” the authors wrote. 

The idea behind this more cautious approach was that the medical professionals thought it safer to wait until more research was done and data on outcomes available before removing barriers to access. 

Lobby Groups

Inevitably, a louder microphone was given to activists who moved into the space and insisted on a “rights-based”, “gender-affirming” and “non-discriminatory” approach to gender health, which sought to de-pathologise gender incongruence and instead insist that any person, including children, had the right to determine their own identity and insist that this be not only be respected, but facilitated by regulators and medical professionals. 

What ended up happening was that an unrestricted “gender-affirmative approach”, described in the report as “one where many (or all) safeguards have been removed and where puberty blockers and cross-sex hormones — coupled with early social transition” became “first-line treatment for gender dysphoria in children/adolescents.” 

This meant that warning signs were ignored. These “red flags” included things such as a dramatic increase in the number of children presenting to gender clinics (the high proportion of these who were girls with “high rates of mental health comorbidities and adverse childhood experiences,”) the disproportionate number of children with autism presenting with gender dysphoria, the increasing number of detransitioners and others expressing regret, and the raising of concerns about the effect of puberty suppression on brain development, future sexual function, and future fertility without corresponding evidence of benefits. 

Evidence-Based Care

In recent years, some countries have put the brakes on unfettered gender transition of children. Finland, Sweden, the UK and Norway have moved to evidence-based care, stressing holistic and multidisciplinary care, with some of these countries banning the use of puberty blockers on kids. Alarmingly, Australia is still refusing evidence-based care and continues to prioritise the individual right to self-identification and non-discrimination over science.

As if this was not sufficient, the report notes that the introduction of bans on so-called conversion therapy have resulted in “exploratory psychotherapy from a neutral therapeutic stance [being] often unavailable in many countries on regions,” which aims to “increase autonomy, decrease distress and improve overall function.”  

These bans on conversion therapy, the authors note, “work against the interests of gender dysphoric children and their families, who may be unable to access the exploratory psychotherapy from a neutral therapeutic stance that is a vital component of evidence-based interventions for such children.”  

Additionally, these laws mean children with gender dysphoria may also be unable to access psychotherapy for conditions such as “suicidal ideation, anxiety, depression and so on— because evidence-based interventions for mental health concerns are misconstrued as forms of ‘conversion therapy.’”  

The report is deeply concerning, and I suggest every parent and grandparent, aunt and uncle, principal and teacher read it and understand the dangers of gender-affirming care.  

This isn’t about “culture wars” or “transphobia” or anything like that. It’s about the safety and wellbeing of children, which should be something that transcends any ideology.

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Republished with thanks to The Catholic Weekly. Image courtesy of Pexels.