the idea that it is unscientific and unethical to use psychotherapy as the default treatment for gender dysphoria is demonstrably wrong. The original
Dutch Protocol, which laid the foundations for pediatric gender transition, insisted on lengthy psychological prescreening of candidates before prescribing them puberty-blocking drugs.
What the Dutch experts knew then, and what researchers know now with even greater confidence, is that minors seeking transition tend to have extraordinarily high rates of mental-health problems, including anxiety, depression, attention-deficit and eating disorders, and autism.
The intuition here is simple: if kids are going to give consent to puberty blockers and cross-sex hormone injections, they should first be determined to be mentally stable and competent.
The psychological co-morbidities clinicians across the West are used to seeing in (mostly female) teenagers who show up for gender-transition procedures typically precede cross-gender identification and are thought to be in themselves the main causes of suicidality—the dreaded outcome that proponents of the affirm-only approach believe justifies allowing minors to consent to life-altering medical interventions.
Existing studies provide no evidence that affirming reduces suicidality, and a new study shows limited evidence that it might worsen the problem.
Affirm-only advocates like to say that their approach has the endorsement of “all major medical associations.” As critics have pointed out, however, the statements of these associations against psychotherapy are based on an egregious misreading of the evidence. For example, when the American Academy of Pediatrics denounced non-affirming approaches as “conversion therapy” in 2018, it based that conclusion entirely on studies done on homosexuality and omitted all relevant studies on youth gender dysphoria. It even interpreted one study as supporting the affirm-only approach, despite the fact that that study explicitly recommended “watchful waiting” (psychotherapy). No one with even superficial familiarity with the politics of gender medicine can take seriously the claim that there is an evidence-grounded consensus in favor of affirmation.
Not only that, but over the past two years medical authorities in Australia, Finland, France, the U.K., and Sweden have recommended severe limitations on affirming therapy, insisting that the evidence for this approach is tenuous at best. The Biden administration is strengthening its commitment to affirming therapy at precisely the moment when the world’s most progressive welfare states are becoming more restrained about the practice.
https://www.city-journal.org/bidens-blighted-executive-order-on-pediatric-gender-medicine
