By Dylan Housman
Last month, President Joe Biden’s Assistant Secretary for Health, Dr. Rachel Levine, said there is no debate among healthcare providers about whether gender-confused children should be provided with so called “gender-affirming” care, which is varying degrees of chemical or surgical sex changes.
Despite Levine’s insistence, a number of mainstream healthcare providers and Western governments disagree.
Levine, the first openly-transgender American to serve in a Senate-confirmed government position, blasted allegedly anti-LGBTQ legislation passed in some red states that restricts the promotion of sexual materials in schools, such as Florida’s parental rights law. Levine also claimed that there is no debate about “gender-affirming” care for kids.
“There is no argument among medical professionals — pediatricians, pediatric endocrinologists, adolescent medicine physicians, adolescent psychiatrists, psychologists, etc. — about the value and the importance of gender-affirming care,” Levine said. (RELATED: New Jersey Middle Schoolers Shown Video Endorsing Hormone Therapy)
Gender-affirming care is a euphemism for medical treatments, oftentimes irreversible, that put a child on a life-altering path to change gender from their biological birth sex. It can include puberty-blocking hormone treatments, surgeries and mental health treatment that “affirms” a child’s belief that they are the wrong gender.
There is plenty of disagreement within the medical community about whether this method of treatment is right for minors, whose brains aren’t yet fully formed and who may not be prepared to make permanent decisions about their reproductive health.
“Levine’s categorical statement is another example of the politicization of this clinical issue,” Dr. Marcus Evans, a psychotherapist who has worked with transgender patients, told the Daily Caller. “Clinicians need to be free to look at clinical issues from different points of view. This is what helps develop our understanding and helps protects patrons from harm.”
Evans was previously on the board of the Tavistock Centre, a major gender clinic in London. He became a whistleblower when he raised concerns about internal policies at the clinic that he felt were mistreating young people who had questions about their gender.
His wife, Dr. Sue Evans, also worked as a psychotherapist at Tavistock. She, too, disagreed with Levine’s claim that the affirmative-care model was the done-and-decided best way to treat youth with gender dysphoria: “The research evidence base for claims that the affirmative model is the best or only one is extremely thin. … It does not match my clinical experience either.”
The Evanses are far from the only physicians who see the issue differently from Levine. There’s an entire group of them called the Society for Evidence Based Gender Medicine (SEGM), which released a point-by-point response to the Biden administration’s endorsement of affirmative care in April.
“The scientific debate about whether social transition is helpful, neutral, or harmful for a gender-dysphoric adolescent long term is not yet settled,” the SEGM said in the statement. “While puberty blockers used to halt early (precocious) puberty have been shown to be reversible, no such studies exist for puberty blockers administered to stop normally timed puberty … Further, no study to date has demonstrated that transition reduces the rate of serious suicide attempts.”
There are others in Europe who disagree with Levine as well. In the U.K., the National Health Service (NHS) commissioned a review of its gender services in 2020 by Dr. Hilary Cass. The Cass Review told the Daily Caller it could not comment on the debate about transgender children in the U.S., but pointed to its recently-released interim report which certainly indicates there’s a debate to be had.
“There is [a] lack of consensus and open discussion about the nature of gender dysphoria and therefore about the appropriate clinical response,” the report explicitly states. “Because the specialist service has evolved rapidly and organically in response to demand, the clinical approach and overall service design has not been subjected to some of the normal quality controls that are typically applied when new or innovative treatments are introduced.”
In Sweden, Dr. Angela Sämfjord started a gender clinic for minors in 2016. She resigned after just two years because she was concerned that there wasn’t enough evidence to justify hormonal and surgical treatments in youth with gender dysphoria. (RELATED: The Rapid Uptick In LGBT Identification Is Driven By People Who Are Actually Straight, Report Finds)
The Swedish government, often heralded by leftists as a progressive model for the U.S. to follow, agrees with her. The country’s National Board of Health and Welfare’s (NBHW) official policy is that “the risks of puberty suppressing treatment with GnRH-analogues and gender-affirming hormonal treatment currently outweigh the possible benefits, and that the treatments should be offered only in exceptional cases.”
Levine’s comment was a response, in part, to guidance issued by the Florida Department of Health on how to treat gender dysphoria in children. It says minors should not be prescribed puberty blockers or hormone therapy, gender reassignment surgery should not be an option for individuals under 18 and that kids should receive support from family and peers and licensed counseling from a professional.
The existence of this guidance, from a state health agency in the U.S., is evidence in itself that there is a debate to be had about the best course of action for treating kids with gender dysphoria. The guidance may be the stance of just one health agency, but it cites evidence from several Western European governments, clinical studies and systematic research reviews.
Despite there being dissent that’s easy to find, Levine’s attitude and the Biden administration’s policy on transgender healthcare are pervasive throughout much of the medical establishment and political activism industry. The Pediatric Endocrine Society claims that gender-affirming care has been “established as the standard of care.” The Columbia University Department of Psychiatry says that attempts to restrict gender-affirming care “run counter to scientific evidence.”
Last April, the ACLU ran an article titled “Doctors Agree: Gender-Affirming Care is Life-Saving Care.” The piece claims that medical experts agree gender-affirming care for kids is “medically necessary.” (RELATED: ‘This Has Gone Too Far’: Transgender Psychologist Reconsiders Work With Trans Youths)
The American Medical Association cited a list of medical groups that back gender-affirming care, and Livestrong.com, citing the Journal of Sex and Marital Therapy, uncritically printed a claim that sex change surgeries are “the best, most effective treatment for gender dysphoria.”
According to Marcus Evans, this false sense of consensus is created not by true broad agreement, but by drowning out disagreement. “It’s not that there’s no debate,” he said, “but that large numbers of people who question current approaches tend to keep their heads down for fear of being accused of being transphobic.”