Editor’s note: The following commentary reflects the personal views of the author and does not represent the official stance of the Christian Medical and Dental Associations
The most popular therapies to treat gender dysphoria in children are dangerous and biased, according to new research published in, “Growing Pains: Problems with Puberty Suppression in Treating Gender Dysphoria.” by Johns Hopkins physicians Hruz, Mayer, and McHugh.
- The effectiveness and success of gender-affirmation therapy and its use of puberty-blocking hormones is unknown, unproven and unapproved by the FDA.
- Despite the claim that puberty suppressors are “fully reversible,” puberty suppressors have not been proven either reversible or harmless.
- Physicians are advising children to endure experimental treatments to treat a mental disorder that has a 95% chance of disappearing with time.
- Gender-affirmation treatments lead most children toward a transgender adulthood, a lifestyle known for its 41% suicide rate.
- Parents deserve full and unbiased information when making choices concerning their children’s health, and an objective review of the evidence concerning the gender-affirmation approach.
You walk into a doctor’s office with your child who isn’t feeling right. The doctor proposes two treatments: one has a 95 percent chance of success and the other increases the risk of death by 41 percent. Which would you choose?
This scenario depicts the gender dysphoria debate stripped to its bare bones. If the child was being seen for any other condition besides gender dysphoria, the later treatment would never even be considered. It would appear that too often, physicians who propose puberty-blocking hormones may be unduly swayed by cultural pressures and emotional appeals.
Physicians and parents alike should understand that they do not need to sacrifice good medicine and good parenting in order to be loving and caring towards these children. Sometimes we have to wipe our children’s and patient’s tears away and still say “no.”
When our children feel like breaking into the medicine cabinet, our hearts skip a beat as we slam the cabinet door shut. And yet, when our children tell us they feel that they want to be a different gender, why would our default be to accommodate that feeling with experimental drug treatments?
With transgender activism sweeping society, children who identify as “trans” are being welcomed into the spotlight. But should such activism and ideology dictate decisions parents make concerning their children's health?
An objective review of the evidence on “transitioning” into another sex is not as cut and dried as Caitlyn Jenner and other trans activists might make it seem.
Leading Medical Experts Concerned About Children
In a paper entitled, “Growing Pains: Problems with Puberty Suppression in Treating Gender Dysphoria,” published this month in The New Atlantis, three medical experts laid out the groundbreaking results of their research.
Physicians Paul W. Hruz, Lawrence S. Mayer, and Paul R. McHugh conclude that families are not being properly educated about their children’s gender dysphoria.
The Johns Hopkins experts conclude that the research, statistics, studies, and results do not support the methods of treatment and therapy which are currently being presented as the healthiest and most loving option for children with gender dysphoria.
Physicians are telling parents that their sons and daughters are trapped in the wrong body and in order to free them from their mental anguish they need to take medical action. This popular form of consultation is known as gender-affirmation therapy. Rather than strive to help the gender dysphoric child to accept their biological gender, the physician or therapist affirms whatever gender the child prefers.
Assuming children to be fully capable of understanding their gender identity at a very young age, gender-affirmation therapy charges children to make decisions that will affect the rest of their lives. We put age restrictions on driving motor vehicles, the consumption of alcohol, enlisting in combat, even when purchasing a rental car, because we recognize the limits of adolescent maturity both mental and physical. And yet physicians are expecting 9 year olds to decide whether or not they’d like to retain their fertility in adulthood.(1)
Unfortunately, many families will never hear about reputable studies that contradict the gender-affirmation position. For instance, one study found that 80-95% (2) of children with gender dysphoria will grow out of gender dysphoria and will embrace the gender of their biological sex. In his 2016 report, Sexuality and Gender,(3) McHugh discovered that the concept of gender is very fluid among children. He insists that children are not fully capable of grasping the concept of gender identity. But this is exactly what is to be expected of children according to the leading medical and advocacy groups who monopolize this discussion.
The medical community is presenting the gender-affirmation approach as the only compassionate response to gender dysphoric children and usually results in the child eventually transitioning into a transgender adult. They characterize all opposing views, such as the opinion of Hruz, Mayer, and McHugh, as bigoted and anti-LGBTQ. Although the opinions of these qualified medical experts are rooted in sober science and a concern for children, the heated rhetoric of the left-wing gender ideologues will characterize them as superstitious religious zealots whose opinions are a form of hate speech. An example of this can be found in a leftist rebuttal of McHugh’s report, in which a “trigger warning” is shown prior to The New Atlantis’ interview with McHugh and Mayer.(4)
This particular counterargument coveys a common example of discrimination in which the credibility of the report is rejected due to the author and publisher’s Judeo-Christian beliefs.
Physicians and patients alike should be wary of any ideology forming a dictatorship over the medical community. Scientific facts do not always coincide with the fashions and fads of the times. Patients ought to be able to find comfort in their physician's reliance upon unbiased data.
Misguided “Guidelines” and Experimental Treatments
Puberty suppression is a hormone intervention that prevents the normal progression of puberty:
“...The testicles and penis of the boy undergoing puberty suppression will not mature, and the girl undergoing puberty suppression will not menstruate. The boy undergoing puberty suppression will have less muscle mass and narrower shoulders than his twin, while the breasts of the girl undergoing puberty suppression will not develop. The boy and girl undergoing puberty suppression will not have the same adolescent growth spurts.”(5)
Medical experts who endorse puberty suppression have been publishing guidelines for treatment which suggest that children as young as age 9 can begin receiving puberty-blockers and then at age 16 be administered cross-sex hormones. Doctors Hruz, Mayer, and McHugh discovered no well-established consensus about the safety and efficacy of these treatments. Regarding treating any patient, particularly a child, administering drugs is a step which should always be taken with great prudence, especially when the medications have not been tried and tested. Hruz, Mayer, and McHugh insist that experimental treatments for children must always be subject to intense scrutiny since 1) children cannot provide their own legal consent, and 2) they are consenting to become a subject to an unproven therapy.
Since puberty-suppression treatments were originally developed to normalize puberty for children who undergo puberty too early, all clinical trials undergone for these medications focused on delaying precocious puberty. Only in 1990 did physicians begin using these medications for treating otherwise physiologically healthy children who exhibited gender dysphoria.
These medications have never been approved by the FDA for treating children with gender dysphoria.
Hruz, Mayer, and McHugh assert, “Whether blocking puberty is the best way to treat gender dysphoria in children remains far from settled, and it should be considered not a prudent option with demonstrated effectiveness but a drastic and experimental measure.”(6)
False Claims of Reversibility
Medical experts who attest to the provenness of puberty suppression also assure their patients and their families, absent any proof, that these medications are “fully reversible.”
Even LGBTQ advocacy groups such as the Human Rights Campaign have noted how “extremely distressing” the development of secondary sex characteristics can be and that “some of these physical changes, such as breast development, are irreversible or require surgery to undo.”(7)
Hruz, Mayer, and McHugh insist, “It seems difficult to expect that a 12-year-old would have an understanding of the effects of these complex medical interventions and of the ‘social consequences of sex reassignment’ when these are matters that are poorly understood by doctors and scientists themselves.”(8)
Should Encouraging Your Child to Transition Take Priority Over Their Health?
Children want to be happy, to “fit in”, to be loved. These are perfectly natural desires which both physician and parents wish for the child. Yet the means to achieve these goals may not be the most avant-garde approach.
Hruz, Mayer, and McHughs urge families to consider the very real possibility that therapies which involve puberty-suppression and cross-sex hormones will inevitably lead to the child desiring sex-reassignment surgery. In other words, gender-affirmation therapy commonly leads to transgenderism. Transgenderism has not been shown to heal children from their existing mental ailments. No follow up studies ensure that the child’s gender dysphoria and their depression and suicidal thoughts will desist. Reliable studies that even transgender advocates cite convey shocking results:
- The transgender population shows a 41% suicide rate compared to the 4.6 rate (9) of the general population.
- People who have had transition surgery are 19 times(10) more likely than average to die by suicide.
Some argue that the morbidity rates associated with transgenderism are entirely due to the unproven “social stress model,”(11) which attributes the social stress of the individual to discrimination and stigmatization. The medical community simply does not yet know why the transgender population experiences such tragic mental health outcomes.
If the goal of the physician and the parent is to relieve a child of mental anguish, they must look these disconcerting facts straight on and accept that there is a high chance that a transgender lifestyle may not be the best solution.
Protecting Our Children
The health of little boys and little girls must never fall victim to the ideological or political movements of the present age.
Protecting our children’s health requires both sober science and loving hearts.
When a daughter struggling with anorexia comes to her parents for help, we would never expect her parents to affirm their daughter’s belief that she is fat. A physician would never prescribe a weight-reduction diet for the daughter.
The anorexia analogy does not sit well with the transgender community. This is largely due to the widespread belief that gender dysphoria is a biological orientation--something we are born with, fixed and immutable. Children struggling with gender dysphoria are constantly consuming what the media and the most popular youtubers inform them concerning transgenderism. Unfortunately, these outlets do not provide reliable medical facts. Qualified medical experts like Hruz, Mayer, and McHughs conclude that there is no evidence that gender dysphoria among children is fixed. McHugh explains these conclusions in the report he co-authored with Dr. Mayer, Sexuality and Gender. In an interview concerning his report, McHugh claimed that the science is never settled, saying “The claim that it is settled now; that the issues such as born that way or you’re fixed or it’s immutable. There is no evidence from the science that those things are correct.”(12)
McHugh’s results may not parallel the party line, but his approach is unbiased and rooted in genuine concern for a vulnerable population prone to severe mental disorders and a high morbidity rate.
As far as medical research can tell us, the path down which physicians and families are ushering vulnerable children is dangerous and even deadly. Parents must not cease in performing their duty as parents: to love and protect. Any therapy that families pursue should be rooted in the best and safest medicine. Perhaps the best therapy a parent can provide is affirming that a child’s worth, value, and identity is not rooted in gender but in the fact that they are loved and wonderfully made.
Paul R. McHugh, M.D. is University Distinguished Service Professor of Psychiatry and a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. He served for twenty-six years as the psychiatrist-in-chief at the Johns Hopkins Hospital.
Lawrence S. Mayer, M.B., M.S., Ph.D. is a scholar in residence in the Department of Psychiatry at the Johns Hopkins University School of Medicine and a professor of statistics and biostatistics at
Arizona State University.
Paul W. Hruz, M.D., Ph.D. is an associate professor of pediatrics, endocrinology, and diabetes and an associate professor of cell biology and physiology at Washington University School of Medicine in St. Louis.