The pressure parents face from Dartmouth Health to medically transition their gender-confused children was brought to light in a guest editorial by endocrinologist Francis Lim-Liberty, MD.
Related: The Trans Suicide Myth and Blackmail Politics
“I see a patient whose parent has been refusing to sign a consent form for gender-affirming hormone therapy for three years,” she writes. Although she promises to administer hormones as soon as her client turns 18, “my biggest fear manifested, would she make it to her 18th birthday just three months away? I worry I won’t see her again.”
In her February 17 Concord Monitor op-ed, “But what if you’re wrong and they’re right? Listening to our trans kids,” Lim-Liberty appears so immersed in Transgenderism that she’s unable to weigh the consequences of administering opposite-sex hormones or to question whether children with gender dysphoria really are at immediate risk of suicide without them.
Although child-transing advocacy group The Trevor Project provides astronomical suicide rates from self-report surveys solicited on social media, if Lim-Liberty dug deeper she would know that suicide among trans-identified youth is rare. Dr. Riittakerttu Kaltiala, Finland’s leading child gender expert, has warned physicians that telling parents their children are in immediate risk of suicide without hormone therapy or that medical transitioning relieves suicidality is “purposeful disinformation.”
Lim-Liberty shares another trans-or-die story about Nick, who had been scheduled to start hormone therapy, but whose parents are reconsidering consent. “His parents worried about Nick changing his mind.” Although she concedes that she has “little data” on how often children later regret their transitions, she flips the question, “But what if he doesn’t change his mind? What happens then?”
With a little research, she could better answer her own question: Children who are spared puberty blockers and hormones will also be spared “extensive and irreversible adverse consequences such as cardiovascular disease, osteoporosis, infertility, increased cancer risk, and thrombosis,” According to a policy statement from Sweden. “This makes it challenging to assess the risk/benefit for the individual patient, and even more challenging for the minors or their guardians to be in a position of an informed stance regarding these treatments.”
Contrary to Lim-Liberty’s reassurance, the rate of regret appears to be accelerating since gender-affirming care has become popular. A 2021 study from an adult gender clinic found that 10% of those receiving gender-affirming care detransitioned or showed a pattern of detransitioning within 16 months. Another 22% disengaged without completing the treatment. The authors concluded “detransitioning might be more frequent than previously reported.”
A 2022 study from a UK primary care practice showed that 12% of patients who started hormonal therapy either detransitioned or expressed regret, while a total of 20% stopped the treatment for a wider range of reasons.
Lim-Liberty offers parents a false dichotomy: The vast majority of children who aren’t affirmed in their belief that they are the opposite gender outgrow their dysphoria. In the most recent and largest study of gender dysphoric youth, 87% were content living as their natal sex when they reached adulthood.
She doesn’t seem to see a downside to hormone therapy. Citing one of the two Dutch studies that serve as the foundation for Dartmouth Health’s puberty-blockers-to-hormones regiment, she asserts that “We know that transgender individuals who received gender-affirming hormone therapy earlier, rather than waiting until completion of puberty . . . had better outcomes in adulthood.” If she had read the actual studies instead of just the abstract she cited, she would know that they proved no such thing.
Among the significant flaws in the studies, the subjects received psychotherapy as well as hormones, but there was no control group. Consequently, we don’t know if their modest short-term improvements in mental health were due to psychotherapy or hormones. Also, those studies didn’t take into account the significant medical consequences of opposite-sex hormones.
Aside from these shortcomings, the Dutch studies aren’t applicable to Lim-Liberty’s practice because they focused on an entirely different population. In contrast to the gender affirmation model practiced in the US, the Dutch researchers selected children who had gender dysphoria from early childhood and who had “no serious comorbid psychiatric disorders.” They also screened out children with autism whose dysphoria might have evolved “from a general feeling of just being different.”
The gender affirming care model assumes that coexisting mental health problems are caused by “minority stress,” and will improve with hormones and surgery. This means that even mentally-ill children are qualified to diagnose themselves and decide their treatment path. As Dartmouth Health Gender Clinic Director John Turco has said, “There is only one test I know of to determine gender identity, and that is to ask the person.”
Lim-Liberty’s unqualified enthusiasm for child transing raises the question as to whether she and her colleagues have even considered why, after systematic reviews of the research, Norway, England, Sweden, and Finland have dropped the affirmative care model as dangerous and ineffective.
Lim-Liberty ends on a happy note by describing transgender siblings. “They are both on gender-affirming hormone therapy, doing well.” Given the long odds of two trans-identifying children in one family, a curious physician might want to explore whether there were environmental factors at play, but Transgenderism isn’t open to scrutiny.
