Pediatric gender clinics: We may look back and ask 'what were we thinking?'

In April 2019 the Twin Cities' flagship facility for pediatric care, Children's Minnesota, launched a clinic for transgender and "gender diverse" young people. Ironically, within days of that opening, the Times of London reported that five clinicians at the Tavistock Centre's Gender Identity Development Service — England's only National Health Service pediatric gender-identity clinic — had resigned "as a matter of conscience."

The clinicians expressed "alarm over the number of adolescents being prescribed body-altering drugs" at Tavistock. "This experimental treatment" is being performed on "very vulnerable children, who have experienced mental health difficulties, abuse, family trauma" that are often "whitewashed" but may contribute to gender confusion, one told the Times. "I felt for the last two years what kept me in the job was a sense there was a huge number of children in danger and I was there to protect them from the service, from the inside," explained another.

Meanwhile, in Minneapolis, Children's new gender clinic is portrayed as an unmitigated good. Yet what's happening in England — where, as here, the number of young people presenting with gender confusion is skyrocketing — suggests that current treatment of pediatric gender-identity problems ignores underlying causes and entails risks that are not being discussed.

Several studies indicate that a strikingly high percentage of young people, especially girls, who identify as transgender have pre-existing autism, ADHD and/or psychological problems, all of which may underlie their gender confusion.

Yet, as the Tavistock clinicians noted, medical personnel are under intense pressure to ignore these "complex histories" in a "rush to accept and celebrate every young person's new transgender identity," in the Times' words. A primary reason, according to the Times, is that transgender lobby groups are "allegedly promoting transition as a cure-all solution for confused adolescents."

As a result, though physicians hesitate to give estrogen to postmenopausal women or testosterone to men because of documented risks, some now dispense these powerful hormones to young people in cross-sex fashion to produce a cosmetic resemblance to the opposite sex. This neglect of normal medical protocol is especially troubling given the serious medical risks to young people.

In the U.S., medicalization of gender dysphoria may begin with puberty blockers, usually around age 12, followed by cross-sex hormones (testosterone and estrogen) by age 16. According to Dr. Carl Heneghan, director of the Centre of Evidence-based Medicine at the University of Oxford, these treatments are "supported by low-quality evidence, or in many cases no evidence at all."

Puberty blockers stunt growth and decrease bone density. Their use followed by cross-sex hormones causes lifelong infertility. Cross-sex hormones also increase risk factors for developing cancers, liver damage, diabetes, blood clots, stroke and heart attack. Long-term effects on brain development are unknown. "Sex reassignment" surgery sometimes follows, including, in the U.S., double mastectomies for females as young as age 13. Young people are being asked to make irreversible, life-changing decisions on these matters at an age when many states bar them from using a tanning bed or getting a tattoo.

Perhaps most disturbingly, gender-dysphoric youth are being advised to embark on this path despite the fact that a great majority of them — 60% to 90% — will desist and embrace their sex if supported through natural puberty, according to research.

The Minnesota Department of Education (MDE) — far from urging a cautious approach to atypical gender identities in youth — is suggesting to young people that gender dysphoria is a normal part of growing up. The Minnesota Student Survey, which MDE administers to ninth- and 11th-graders throughout the state, asks 15-year-olds to specify if they are "transgender," "genderqueer," "genderfluid," "nonbinary," "pansexual," "trans male" or "trans female," or "questioning." It also asks them whether others would describe their "appearance, style, dress" or the way they "walk or talk" as "very or mostly feminine," "equally feminine and masculine," or "very or mostly masculine."

In July 2017, MDE approved a "transgender tool kit" for distribution to all public schools in Minnesota. The tool kit instructs schools to treat "transgender and gender nonconforming students" as the gender they identify with for bathroom and locker room use, sports team participation, overnight accommodations on school trips, dress codes, pronoun use and school records.

It insinuates that schools that don't comply could face legal problems. It also implies — chillingly — that if parents of gender-dysphoric young people are judged to be insufficiently supportive, "the student support team should follow their protocol for reporting child neglect or harm."

So long as society encourages young people to embrace gender identities contrary to biological sex, while failing to inform them of the risks, we can expect the number of gender-dysphoric children to grow. In this regard, Minnesota educators and physicians should heed the Tavistock clinicians' warning.

"It felt as if we were part of something that people would look back on in the future, and ask, what were we thinking?" one told the Times. She fears that "lots and lots of de-transitioners" will conclude "their bodies were mutilated as young people" and "will ask, why did you let me do this?"

Katherine Kersten is a senior policy fellow at the Center of the American Experiment. She is at kakersten@gmail.com.