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False Claim Underlying the Support for “Gender Affirming Care” for Children

In March of this year, we addressed the medical malpractice lawsuit brought by Chloe Cole, a young woman who underwent medical treatment, including hormone blockers and breast removal surgery, while a minor.  Miss Cole realized that transitioning to a man was not the answer to her various mental health issues, and has transitioned back to the sexual identity with which she was born. 

In an interview with Fox News Host Tucker Carlson, Cole said “I made an adult decision as a child… I want to hold the adults that put me in harm’s way accountable because what happened to me is horrible, but it also didn’t only happen to me, that’s the worst part. It’s happening to children all over the U.S., all over the West, and it’s spreading all over the world.” 

 Miss Cole is absolutely right.  The transitioning of children from male to female, and female to male, is happening everywhere.

And much of this unnecessary medical treatment is based on a lie, unsupported by objective evidence.

In Minnesota, the State’s House of Representatives recently passed a bill “that would establish the state as a ‘trans refuge’ for children who are seeking transgender medical procedures but who may be denied ‘gender-affirming care’ in other states…Democrats supporting the bill say the legislation will protect transgender people, their families and healthcare providers from facing legal repercussions for traveling to Minnesota to obtain cross-sex hormone prescriptions or sex-change procedures.”

The Bill, HF 146, provides that “(a) law of another state that authorizes a state agency to remove a child from the child’s parent or guardian because the parent or guardian allowed the child to receive gender-affirming health care…is against the public policy of this state and must not be enforced or applied in a case pending in a court in this state. A court order for the removal of a child issued in another state because the child’s parent or guardian assisted the child in receiving gender-affirming care in this state
must not be enforced in this state.”  Further, “(n)o subpoena shall be issued and no foreign subpoena shall be recognized in this state in a criminal or civil matter if the subpoena is related to a violation of another state’s laws when the other state’s laws are designed to interfere with an individual’s right to receive gender-affirming health care.”

The Bill defines “gender affirming care” as “medically necessary health care or mental health care that respects the gender identity of the patient, as experienced and defined by the patient.”

HF 146 is sponsored by Rep. Leigh Finke, a member of the Democratic-Farmer-Labor Party and Minnesota’s first transgender lawmaker.  In support of the Bill, Finke said “Gender-affirming care is lifesaving health care…(w)ithholding or delaying gender-affirming care can have a dramatic impact on the mental health of any individual who needs it. Rates of depression, suicide, substance abuse are dramatically higher in transgender and gender-expansive individuals who lack access to care.”

Is this true?  Are rates of suicide higher for minors who are not allowed to transition before they reach their majority?  In general, do adults who transition commit suicide any less than those who do not?  Is “gender affirming care” actually “medically necessary?”

Many of the doctors who are engaged in the booming business of gender transition surgery seem to think so.  According to the Notice of Intent to sue filed by the attorney for Chloe Cole, “Chloe and her parents were…informed that the only way to resolve Chloe’s gender dysphoria was to proceed with opposite sex hormone therapy and surgical intervention. Chloe is informed that (the medical professionals) presented Chloe’s parents with misleading statistics about transgender suicide and gave them the ultimatum: ‘Would you rather have a dead daughter or a live son?’”

There is medical research available that indicates this choice is false – that “gender affirming care” is not the least bit “medically necessary” or even “lifesaving.”

A study conducted in Sweden and published in 2011 found that of “324 sex-reassigned persons (191 male-to-females, 133 female-to-males)” studied between 1973 and 2003, “(t)he overall mortality for sex-reassigned persons was higher during follow-up…than for controls of the same birth sex, particularly death from suicide…Sex-reassigned persons also had an increased risk for suicide attempts…and psychiatric inpatient care.”  The conclusion of this study? “Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.”

In other words, people who transitioned from one sex to the other were more likely to commit suicide than those who did not.

The Swedish study is not the only scientific analysis that has come up with similar findings.  According to the Society for Evidence Based Gender Medicine (SEGM),  “(i)n October 2019, the American Journal of Psychiatry (AJP) published a study from the Karolinska Institute in Sweden, and the Yale School of Public Health which reported that ‘gender-affirming’ surgeries for gender dysphoric patients are associated with improved mental health outcomes…(t)he study analyzed health records of 2,679 Swedes diagnosed with gender dysphoria between 2005 and 2015 to determine whether hormonal or surgical treatments improved their mental health over time… After the study was published, many researchers and scientists (including some SEGM advisors) alerted the AJP to multiple serious methodological problems that challenged the study’s conclusion. In response, the AJP editor requested an independent statistical review of the data, which led to a reanalysis of the data and an official correction. When gender dysphoric patients who received surgeries were compared to those who did not have surgeries, there was no statistically significant difference in their mental health utilization. Nine months after the study’s original publication, the AJP stated, ‘the results [of the reanalysis] demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts.’” 

In fact, the SEGM’s official position is that “(t)he mental health needs of people suffering from gender dysphoria are significantly greater than those of the general population, which confirms previous research…No mental health benefit of hormonal interventions was demonstrated (and) No mental health benefit of ‘gender-affirming’ surgery was demonstrated.”

There are, of course, other studies which support the “medical necessity” for “gender affirming” surgery.  But Sweden stands behind the findings of their country’s medical researchers; “Sweden decided in February 2022 to halt hormone therapy for minors except in very rare cases, and in December, the National Board of Health and Welfare said mastectomies for teenage girls wanting to transition should be limited to a research setting. ‘The uncertain state of knowledge calls for caution,’ Board department head Thomas Linden said in a statement in December…The profile of those diagnosed is often complex, according to Linden, as gender dysphoria often occurs in those also suffering from other diagnoses, such as attention deficit and eating disorders or autism…Neighbouring Finland took a similar decision in 2020, while France has called for ‘the utmost reserve’ on hormone treatments for young people.” 

In an article for the Heritage Foundation, Ryan Anderson writes that “the medical evidence suggests that sex reassignment does not adequately address the psychosocial difficulties faced by people who identify as transgender. Even when the procedures are successful technically and cosmetically, and even in cultures that are relatively ‘trans-friendly,’ transitioners still face poor outcomes… a review of ‘more than 100 follow-up studies of post-operative transsexuals’ by Birmingham University’s Aggressive Research Intelligence Facility (found that) none of the studies provides conclusive evidence that gender reassignment is beneficial for patients. It found that most research was poorly designed, which skewed the results in favor of physically changing sex. There was no evaluation of whether other treatments, such as long-term counseling, might help transsexuals, or whether their gender confusion might lessen over time.” 

In other words, supporters of gender reassignment surgery, particularly for minors, may sincerely believe that young people with gender dysphoria absolutely need hormone blockers and the removal of their breasts or sexual organs to save their lives.  But if so, those true believers in the performance of such radical medical procedures on children are proponents of a lie, unsupported by responsible medical research.

Before the State of Minnesota becomes a “trans refuge” and refuses to return minors to states which outlaw medical experiments on children, perhaps a more extensive review of the medical support for a belief that any lives are saved by “gender affirming care” is prudent and necessary.

Judge John Wilson (ret.) served on the bench in NYC

Illustration: Pixabay