A Damning Indictment of Gender ‘Affirmation’

National Review Online

Monday, April 15, 2024

 

Over the past 15 years, the number of patients seen annually at NHS England’s gender youth clinic has increased from 50 to 5,000 young people. At the same time, childhood gender dysphoria, once a condition primarily affecting small boys, began appearing in a new population in unprecedented numbers: adolescent females with no prior history of gender distress.

 

The shift in patient population coincided with the British gender clinic’s embrace of the activist-driven “gender affirmation” model of treatment. The approach, which is pervasive throughout the United States, has three stages.

 

First, “social transition”: treating children as though they were really the sex with which they identify. For example, addressing a gender-distressed girl by male pronouns and encouraging her to use the men’s room. Second, hormones: a regimen of “puberty-blockers” most often followed by cross-sex hormones. Third, surgery: having healthy body parts surgically removed or refashioned to resemble those of the opposite sex.

 

As early as 2015, advocacy groups in the U.K. sounded the alarm about the clinic’s life-altering interventions on young patients. A handful of journalists, undeterred by accusations of “transphobia,” doggedly reported on the clinic’s activities. Whistleblowers within the medical profession and even some of the clinic’s own staff went public with firsthand accounts of vulnerable patients being put on the transgender conveyor belt.

 

The public demanded answers. What evidence did the NHS gender clinic have to justify its approach? This, in essence, was the question NHS England asked Hilary Cass, former president of the Royal College of Pediatricians, in 2020.

 

Her final report was released on Wednesday, and the NHS immediately implemented some of her recommendations. Though measured in tone, it is a damning indictment of the NHS gender clinic and of the “affirmation” model more generally. She finds that the entire clinical approach to children who think they’re transgender is “built on shaky foundations” and “remarkably weak evidence.” She notes that studies “are exaggerated or misrepresented by people on all sides of the debate,” though, of course, the burden of proof ought to be on those wishing to experiment on gender-distressed youth.

 

Even social transition demands caution, Cass notes, as it is “not a neutral act” but an “active intervention” that makes a patient “more likely to proceed to a medical pathway.” School personnel who lack “appropriate clinical training” should refrain from socially transitioning children.

 

Cass sets the issue of transgender identification in the broader context of a teen mental-health crisis, noting that adolescents’ “unprecedented online access” has left them vulnerable and recommending greater investigation of the link between the “consumption of online pornography and gender dysphoria.”

 

Gender services, she concludes, should meet “the same standards” we expect of other child-health services.

 

Sometimes it is the most obvious statements of truth that are the most powerful. As victims of “gender affirmation” continue to come forward, it is becoming ever clearer that we are living through one of the most shameful chapters in the history of Western medicine.