Medical consensus on gender reassignment of children is disappearing. We have to protect the children

The Supreme Court accused California in early March of forcing schools to hide students’ transgender status from their parents.

The legal implications of this case are important, but they also reveal deep divisions about how society should respond when children experience sexual harassment — and how public health officials like us can shape policy to help those children thrive.

Until recently, this debate was dominated by hardline sexologists, who insisted on validation at any cost.

In their opinion, a girl who thinks she is a boy is a boy. Failure to affirm this new identity, they believe, will cause more harm than irreversible surgery or a lifelong form of cross-sex hormones.

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In California, the road to this strong intervention begins in the classroom, where state law requires teachers to hide children’s gender confusion from parents, even if that means sitting across from them at parent-teacher conferences and lying about not lying to the very people most responsible for the care and well-being of those children.

Socially changing children at school puts them on a collision course with sex-averse medical interventions that cause low bone density, infertility, cardiovascular problems and other painful, expensive health problems.

There is no ramp. California’s ban on “conversion therapy” applies not only to the abusive practices that many people associate with that term, but to any counseling that can reduce a child’s sexual distress without changing it. (Many states have similarly broad bans on their books, though the Supreme Court recently struck down Colorado’s.)

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Those policies are based on “weird theory” rather than science, but after a long campaign of intimidation and intimidation, activists have managed to unite the medical profession with their ideology. A few years ago, they would say “[e]major medical organization” considers abstinence intervention for transgender youth to be “safe and life-saving.”

But that conviction was not accompanied by strong evidence.

Thankfully, the situation has changed. There is a growing international consensus that gender activists were wrong. Scientific reviews in Sweden and Finland, as well as a strong Cass report from the UK helped convince those countries to significantly scale back child and adolescent sex prevention interventions.

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Last fall, the US Department of Health and Human Services (HHS) published a comprehensive review titled “Treatment for Children’s Gender Dysphoria: A Review of Evidence and Best Practices,” which reached the same conclusion: that medically transitioning children has no proven benefits.

The choice between “a mutant son or a dead daughter” convinced thousands of parents to authorize interventions that irreparably harmed their children. It turned out to be a false dichotomy.

Socially changing children at school puts them on a collision course with sex-averse medical interventions that cause low bone density, infertility, cardiovascular problems and other painful, expensive health problems.

Evidence also suggests that transgender children were not just “born in the wrong body” but may be suffering from deeper problems.

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The recent rise in youth gender dysphoria has coincided with a significant decline in youth mental health (probably driven by smartphones and social media). Both styles were very popular among girls.

One empirical study found that 63% of adolescents who express sexual distress have at least one neurodevelopmental disorder or at least one co-occurring mental disorder.

These children do not need puberty drugs and hormones. They need psychotherapy, family counseling, a thorough clinical evaluation, and perhaps treatment for anxiety or depression – not rushing into irreversible medical intervention.

Based on these findings, CMS and HHS took action in December by proposing two new rules to ensure that taxpayer-funded health plans are guided by evidence, not opinion. The first stops taxpayer dollars from funding sexual abstinence interventions for children through CHIP and Medicaid; the second prevents hospitals that perform these interventions from participating in Medicare and Medicaid, given the serious safety risks to children.

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In January, CMS convened all the major medical organizations involved in child sexual abstinence interventions and held “grand rounds” on the available evidence. A month later, the American Society of Plastic Surgeons issued a bold and principled statement admitting that “there is insufficient evidence to demonstrate a favorable risk-benefit ratio … associated with gender and surgical intervention in children and adolescents.”

Those policies are based on “weird theory” rather than science, but after a long campaign of intimidation and intimidation, activists have managed to unite the medical profession with their ideas.

Mehmet Oz, MD, MBA is the director of the Centers for Medicare and Medicaid Services.