WASHINGTON�The U.S. is becoming an outlier among many Western nations in the
way its national medical institutions treat children suffering from distress
over gender identity.

For years, the American healthcare industry has staunchly defended medical
interventions for transgender minors, including puberty blockers, which
suppress the physical changes of adolescence as a treatment for those
distressed over their gender.

The European medical community, by contrast, is expressing doubts about that
approach. Having allowed these treatments for years, five countries�the U.K.,
Sweden, Finland, Norway and France�now urge caution in their use for minors,
stressing a lack of evidence that the benefits outweigh the risks. This
month, the U.K.�s publicly funded National Health Service for England limited
the use of puberty blockers to clinical trials, putting the drugs beyond the
reach of most children.

�These countries have done systematic reviews of evidence,� said Leor Sapir,
a fellow who studies transgender care at the conservative-leaning Manhattan
Institute think tank. �They�ve found that the studies cited to support these
medical interventions are too unreliable, and the risks are too serious.�

Many countries still allow puberty blockers as a clinical option, including
Canada, Spain and Australia. Some in those countries also are urging
curtailment. In Italy, for example, the president of the Italian
Psychoanalytic Society wrote a public letter to the Italian prime minister in
January expressing �serious concerns� over the use of puberty blockers.

In a congressional hearing last week, GOP politicians and their expert
witnesses repeatedly cited European examples of increased caution and
portrayed Democrats and the U.S. medical community as having gone too far in
making treatments readily available for minors.

�It�s beneficial to see European countries coming to their senses,� said Rep.
Dan Crenshaw, (R., Texas) in an interview after citing U.K. systematic
evidentiary reviews of puberty blockers in last week�s hearing. In a sign
that Republicans plan to make transgender-care issues a 2024 campaign theme,
Crenshaw said at the hearing: �This is the issue of our time. This is a hill
we�re gonna die on.�

Democrats say Republicans are attacking transgender youth to score political
points and are backing dangerous bans and restrictions on treatments that
will cause children harm.

�They are telling parents that Republican politicians know better than they
do what is best for their child,� said Rep. Frank Pallone Jr., (D., N.J.) at
the hearing last week. �This is the height of hypocrisy from a group that
supposedly believes in limited government.�

A recent poll by the Washington Post and KFF, an independent polling and
research firm, showed 68% opposed to the use of puberty blockers in children
ages 10 to 14. The poll, published in May, was conducted late last year.

Since then, well over a dozen GOP-run states have issued restrictions on
medical interventions as part of transgender care. Health providers in Texas,
for example, risk losing their medical licenses if they provide puberty
blockers, surgeries or hormone treatments to most transgender minors under a
GOP-led law that goes into effect in September.

The U.S. medical community hasn�t wavered in its support for medical
interventions and continues to recommend puberty blockers and hormones for
minors as a clinical option. Unlike the concerns expressed by many
authorities in Europe, U.S. medical associations often treat the science
behind such medical interventions as settled.

Last week, delegates at the annual meeting of the American Medical
Association endorsed a resolution�co-sponsored by the American Academy of
Pediatrics, the American Association of Clinical Endocrinology and others�
that reiterated support for access to medical interventions, saying that GOP
claims about transgender care �do not reflect the research landscape.�

Other states, reflecting Democratic priorities, are welcoming transgender
minors seeking such treatments. Last week, New York introduced new public-
school guidance that allowed teachers to keep secret a child�s social
transition, in which students change their name or pronouns to reflect an
identity other than the gender at birth.

Some students �have not talked to their families about their gender identity
because of safety concerns or lack of acceptance and may begin their
transition at school without parent/guardian knowledge,� the guidance said.

Some Republicans say parents should be involved. �Parents are the people who
are best positioned to make these judgments,� said former New Jersey governor
and 2024 Republican presidential candidate Chris Christie, speaking on CNN�s
�State of the Union� on Sunday. Christie called for states to ensure
�parental involvement at every step along the way.�

Puberty blockers were once embraced by many countries, becoming the
international standard with the �Dutch Protocol,� when clinicians in the
mid-1990s pioneered the use of drugs to suppress estrogen and testosterone.
Their use delays breast growth, the widening of hips, and menstruation in
women. In males, they suppress the growth of facial hair and deeper voices.

Some 98% of adolescents who began puberty blockers before the age of 18
continued to use cross-sex hormones into adulthood, based on a 2022 study
from the Netherlands. That has some critics saying that, rather than allowing
a patient to outgrow the confusions that come with puberty, it locks children
into feelings of being the wrong gender.

The U.S. Food and Drug Administration approved puberty blockers in 1993 for
children going through puberty at an unusually early age. But the FDA hasn�t
approved puberty blockers to treat gender dysphoria, the distress felt over a
conflict between a child�s gender identity and the sex recorded at birth.

Given as a shot or an implant, the drugs can lead to less development of
genital tissue, complicating future gender-transition surgeries. Other side
effects may include hot flashes, weight gain, headaches, decreased bone
density and mood changes. They may also affect later fertility.

--
Let's go Brandon!

WASHINGTON�The U.S. is becoming an outlier among many Western nations in the
way its national medical institutions treat children suffering from distress
over gender identity.

For years, the American healthcare industry has staunchly defended medical
interventions for transgender minors, including puberty blockers, which
suppress the physical changes of adolescence as a treatment for those
distressed over their gender.

The European medical community, by contrast, is expressing doubts about that
approach. Having allowed these treatments for years, five countries�the U.K.,
Sweden, Finland, Norway and France�now urge caution in their use for minors,
stressing a lack of evidence that the benefits outweigh the risks. This
month, the U.K.�s publicly funded National Health Service for England limited
the use of puberty blockers to clinical trials, putting the drugs beyond the
reach of most children.

�These countries have done systematic reviews of evidence,� said Leor Sapir,
a fellow who studies transgender care at the conservative-leaning Manhattan
Institute think tank. �They�ve found that the studies cited to support these
medical interventions are too unreliable, and the risks are too serious.�

Many countries still allow puberty blockers as a clinical option, including
Canada, Spain and Australia. Some in those countries also are urging
curtailment. In Italy, for example, the president of the Italian
Psychoanalytic Society wrote a public letter to the Italian prime minister in
January expressing �serious concerns� over the use of puberty blockers.

In a congressional hearing last week, GOP politicians and their expert
witnesses repeatedly cited European examples of increased caution and
portrayed Democrats and the U.S. medical community as having gone too far in
making treatments readily available for minors.

�It�s beneficial to see European countries coming to their senses,� said Rep.
Dan Crenshaw, (R., Texas) in an interview after citing U.K. systematic
evidentiary reviews of puberty blockers in last week�s hearing. In a sign
that Republicans plan to make transgender-care issues a 2024 campaign theme,
Crenshaw said at the hearing: �This is the issue of our time. This is a hill
we�re gonna die on.�

Democrats say Republicans are attacking transgender youth to score political
points and are backing dangerous bans and restrictions on treatments that
will cause children harm.

�They are telling parents that Republican politicians know better than they
do what is best for their child,� said Rep. Frank Pallone Jr., (D., N.J.) at
the hearing last week. �This is the height of hypocrisy from a group that
supposedly believes in limited government.�

A recent poll by the Washington Post and KFF, an independent polling and
research firm, showed 68% opposed to the use of puberty blockers in children
ages 10 to 14. The poll, published in May, was conducted late last year.

Since then, well over a dozen GOP-run states have issued restrictions on
medical interventions as part of transgender care. Health providers in Texas,
for example, risk losing their medical licenses if they provide puberty
blockers, surgeries or hormone treatments to most transgender minors under a
GOP-led law that goes into effect in September.

The U.S. medical community hasn�t wavered in its support for medical
interventions and continues to recommend puberty blockers and hormones for
minors as a clinical option. Unlike the concerns expressed by many
authorities in Europe, U.S. medical associations often treat the science
behind such medical interventions as settled.

Last week, delegates at the annual meeting of the American Medical
Association endorsed a resolution�co-sponsored by the American Academy of
Pediatrics, the American Association of Clinical Endocrinology and others�
that reiterated support for access to medical interventions, saying that GOP
claims about transgender care �do not reflect the research landscape.�

Other states, reflecting Democratic priorities, are welcoming transgender
minors seeking such treatments. Last week, New York introduced new public-
school guidance that allowed teachers to keep secret a child�s social
transition, in which students change their name or pronouns to reflect an
identity other than the gender at birth.

Some students �have not talked to their families about their gender identity
because of safety concerns or lack of acceptance and may begin their
transition at school without parent/guardian knowledge,� the guidance said.

Some Republicans say parents should be involved. �Parents are the people who
are best positioned to make these judgments,� said former New Jersey governor
and 2024 Republican presidential candidate Chris Christie, speaking on CNN�s
�State of the Union� on Sunday. Christie called for states to ensure
�parental involvement at every step along the way.�

Puberty blockers were once embraced by many countries, becoming the
international standard with the �Dutch Protocol,� when clinicians in the
mid-1990s pioneered the use of drugs to suppress estrogen and testosterone.
Their use delays breast growth, the widening of hips, and menstruation in
women. In males, they suppress the growth of facial hair and deeper voices.

Some 98% of adolescents who began puberty blockers before the age of 18
continued to use cross-sex hormones into adulthood, based on a 2022 study
from the Netherlands. That has some critics saying that, rather than allowing
a patient to outgrow the confusions that come with puberty, it locks children
into feelings of being the wrong gender.

The U.S. Food and Drug Administration approved puberty blockers in 1993 for
children going through puberty at an unusually early age. But the FDA hasn�t
approved puberty blockers to treat gender dysphoria, the distress felt over a
conflict between a child�s gender identity and the sex recorded at birth.

Given as a shot or an implant, the drugs can lead to less development of
genital tissue, complicating future gender-transition surgeries. Other side
effects may include hot flashes, weight gain, headaches, decreased bone
density and mood changes. They may also affect later fertility.

--
Let's go Brandon!