Although all American youth are facing a mental health crisis, the situation is far worse for those identifying as transgender. They are at substantially elevated risk for adverse mental health outcomes and suffer from extremely high suicide rates.
The condition they experience is “gender dysphoria,” psychological distress caused by their gender identity and biological sex being in conflict.
According to modern gender ideology, there is but one way to respond to these feelings: “gender-affirming” treatments. These include 1) hormone replacement therapy (to either give the patient hormones of the opposite sex or preemptively block the puberty-causing hormones of the patient’s biological sex), 2) social transition (to present oneself as the opposite sex), and 3) sex-reassignment surgery. Because gender is determined solely by one’s personal identity, any effort to help dysphoric teens align their gender identity with the body they were born into is useless at best, and cruel at worst.
Assuming this is true – as many young people do after consistently hearing this message from major media sources – it is understandable how hard some fight for transgender youth to receive these treatments, the supposed only solution to their problem.
But this message is not true. And society should recognize the tactic transgender activists are employing. After all, the key to good advertising is convincing the public they have a problem and that only you have the solution.
Two years ago, Craig Monger wrote an opinion piece discussing the phenomenon of gender dysphoria, the “peer contagion” that is having a devastating effect on the mental health of America’s youth.
Before we “sacrifice the next generation under the guise of kindness and cultural acceptance,” Monger wrote, we must answer whether treating a child suffering from gender dysphoria with hormones or surgery to alter their biological sex actually helps them.
Contrary to what progressives believe, Monger explained, this question remains unanswered. Authorities and experts have been rolling back their claims about the safety, effectiveness, and reversibility of gender-affirming treatments, Monger wrote, and de-transitioners (transgender people who regret their “gender-affirming” treatments) are increasing in number.
Today, there is still no consensus on how to treat gender dysphoria. There are a few reasons for this.
First, many Americans have moral objections to “gender-affirming” treatments (60% think a person’s gender is determined by that person’s sex at birth).
Second, Americans are rightly skeptical of an industry that claims it has the only solution to a nationwide problem (particularly when it’s the American medical industry, known for its financial motive).
Third, it has not been scientifically proven that “gender-affirming” treatments are most effective. For example, one study found that, after sex-reassignment surgery, transgender people still have “considerably higher risks for mortality, suicidal behavior, and psychiatric morbidity than the general population.”
While there are dozens of studies supposedly evidencing the effectiveness of gender affirmation, there is a fundamental problem with all of them. Since modern gender ideology considers any effort to help a transgender child reconcile their identity with their birth sex “unethical” (and “gender-denying”), researchers say that randomized control trials to compare treatment methods – giving one group “gender-affirming” treatments and others a placebo – cannot be done, “because it is unethical to withhold treatment or administer potential harmful interventions.”
In other words, researchers are assuming that “gender-affirming” treatments are effective for gender dysphoria – and are the only effective treatment – therefore concluding that it is unethical to withhold them in order to conduct a study, even though the purpose of the study is to determine the effectiveness of “gender-affirming” treatments. This bias cannot be overlooked.
Based on this fallacy, instead of control trials, researchers retrospectively compare the mental health of transgender people who have received “gender-affirming” treatments with those who have not. However, this does not produce reliable results.
Although a link between “gender-affirming” treatments and positive mental health in transgender youth may be found, this is more likely attributable to the child’s home environment than the medical treatments themselves. Because these treatments usually require parental approval, the children receiving them are more likely to have parents who accept their transgender identity. And it has been found that, in the short term, transgender youth in transgender-accepting families are less likely to have mental health problems.
Therefore, these studies do not prove that “gender-affirming” treatments improve gender dysphoria. Even a liberal source admits that, in most studies, “The mental health improvement … may partially be due to living in a gender-affirming family environment rather than the effects of hormone therapy alone.”
To really determine the efficacy of “gender-affirming” treatments in transgender youth, we need to know what happens to them when they grow up. But it is too early to conduct such a study.
In the meantime, because these treatments are largely irreversible, we cannot allow minors to access them.
Alabama thankfully understands this. When Monger wrote his article two years ago, the Alabama Legislature was debating Senate Bill 184, the Vulnerable Child Compassion and Protection Act (VCAP), making it a class C felony to administer sex-modification hormones or surgery to a minor.
Since Monger’s article, VCAP has been passed, challenged, and enjoined. However, just last week, the injunction was lifted, so VCAP can be enforced while it awaits a full trial later this year.
Gender ideology claims that science is settled and that dysphoric youth shouldn’t try to re-align their gender identity with the body they were born in. Instead, to the greatest extent possible (i.e. as much as they can pay for), they should change their bodies to match their mental state.
But this is not their only hope. I hope VCAP helps us prove this to them.
