By Joyce Shelton, Ph.D.
Despite President Trump’s recent executive orders, one declaring that there are only two genders, male and female, and promising to restore “biological truth to the federal government,” and another “protecting children from chemical and surgical mutilation”, controversies surrounding transgender ideology and the treatment of sex/gender-confused youth remain. Daily, beleaguered parents are faced with making heart-rending, life-altering decisions regarding the best care for their beloved children. The ideology-driven advice they receive is generally more hyper-emotional than rational. How can we help? I propose that we eschew emotions and turn toward real evidence-based science to inform our thinking and decision-making about such treatments. We start by clarifying what we know and de-coupling pseudoscience from real science.
Let’s review some basic biology, which, despite hundreds of years of acceptance, has in recent years come up for debate. Simply stated, biological sex in human beings is binary. It is hard-wired into our DNA and is evidenced by the development of primary sex organs, testes producing sperm in males and ovaries producing eggs in females. Reproduction depends on this fact. If it were not true, there would be no human beings (stock photo above). Can a person’s feelings or preferences determine their biological sex? No. If someone feels that he/she is not the sex that his/her DNA indicates, should he/she attempt a medical change? No. This feeling may be temporary or due to a mental health disorder termed gender dysphoria. Genetic testing of individuals with gender dysphoria has not found any link with underlying genetic sex anomalies. Therefore, a rational approach to persistent sex/gender confusion would be to seek psychotherapy, not gender-altering medicinal or surgical interventions.
Such science-based realities have not, recently, dictated the treatment of gender dysphoria. The World Professional Association for Transgender Health (WPATH), the group that has steered the global treatment of gender-questioning youth for years, has claimed their purpose is “to promote evidence-based care.” However, in March 2024, files leaked from WPATH demonstrated a glaring absence of any genuine scientific justification for their Standards of Care. The WPATH Files revealed “that the organization does not meet the standards of evidence-based medicine, and members frequently discuss improvising treatments as they go along.” This is called pseudoscience. The American College of Pediatricians states “There is not a single long-term study to demonstrate the safety or efficacy of puberty blockers, cross-sex hormones and surgeries for transgender-believing youth. This assessment means that youth transition is experimental, and therefore, parents cannot provide informed consent, nor can minors provide assent for these interventions.” Regardless, many in the medical community have chosen to follow transgender ideology over scientific evidence and, as the NY Post reports, a total of 13,994 minors in the US were given these potentially harmful treatments for gender dysphoria between 2019 and 2023.
Potential suicide is the often repeated incentive used to intimidate parents into consenting to gender-altering treatments for their minor children. WPATH and others have claimed, without evidence, that suicidal risk is exacerbated in untreated gender-confused youth. In fact, a thirty year, controlled study definitively showed just the opposite, that “mortality from suicide was strikingly high among sex-reassigned persons” (treated with hormones and surgery) and, furthermore, “sex-reassigned persons were at increased risk for suicide attempts.” Their data invalidate the standard suicidal threat. Nevertheless, in 2015, the National Institutes of Health (NIH) awarded Dr. Johanna Olsen-Kennedy a $9.7 million grant to re-investigate this concern. Dr. Olsen-Kennedy suppressed publication of her scientific results, which showed no reduction of depression or suicidal tendencies in trans-youth treated with puberty blockers, because the data did not fit her ideological narrative. The Congressional Oversight and Accountability Committee directed the NIH to submit all records from her study, stating that “deliberately mischaracterizing and withholding the results of the Trans Youth Care study has serious implications for the health and safety of children who are subjected to ‘gender affirming’ medical procedures, many of which are irreversible and hold lifelong implications despite lacking adequate scientific support for their efficacy or safety.” Dr. Olsen-Kennedy’s blatant bias politicizes and undermines trust in real science, the credibility of which relies on transparency and impartiality.
The Cass Review, a rigorous UK study released in April 2024, clearly demonstrated that there was “remarkably weak scientific evidence” to support the use of puberty blockers and cross sex hormones to treat gender-confused minors. It found that the drugs provided no proven benefits and no suicidal risk reduction, but did have high potential for harmful, long-term effects (e.g. osteoporosis, mental depression, cognitive impairment, seizures, infertility, and cancer). This study has convinced the UK and other European countries to turn away from such medical treatments, particularly for minors. Sadly, many in the US have been reluctant to follow suit.
Given what we now know about these damaging, ideology-driven treatments, it is difficult to understand why US medical professionals persist in defending them. Is it because they have placed their confidence in pseudoscience? Or is it because they have chosen profits over ethics? Either reason is unconscionable. As fellow TN-CBC contributor, Dr. Janet Lillistrand has said, it only leads patients to distrust medical doctors. The politicization and erosion of trust in real science in recent times is lamentable. The loss of trust in medical professionals could be life-threatening.
There is hope that the tide is turning. Laws banning so called “gender-affirming” treatments have been passed in twenty six US states. A challenge to Tennessee’s ban is currently under consideration in the Supreme Court (US vs. Skirmetti). Rational medical professionals filed an amicus brief in an attempt to bring real science to bear on the eagerly awaited decision. Executive orders notwithstanding, we know that such change does not happen immediately and we cannot afford to wait for truth to be legislated. If your families, church or community members, or others you care about are faced with related concerns regarding their children, show them real love by directing them to real science before they make any irrevocable decisions.
Resources to help parents and families deal with transgender ideology narratives and consequences:
The American College of Pediatricians:
Child and Parental Rights Campaign:
Lost in Trans Nation: A Child Psychiatrists Guide Out of the Madness, Miriam Grossman, Skyhorse Publ, 2023.
The Genesis of Gender, Abigail Favale, Ignatius Press, 2022.
Begotten or Made?, Oliver O’Donavan, The Davenant Press, 2022.
