Magazine | December 09, 2019, Issue

The Tragedy of the ‘Trans’ Child

(Left: Elena Mazzotta/EyeEm; Right: Achim Schfer/EyeEm)
In Texas, the case of James Younger points to a disturbing trend in the treatment of gender-confused youth

His mother pulling him by one arm, his father pulling him by the other, seven-year-old James Younger, dressed in a skirt, looks distressed and confused. His mom, Anne Georgulas, wins the struggle and rests him on her hip. His dad, Jeffrey Younger, calls 911. “Why?” asks James. “She was supposed to give me custody,” his father replies. A video recording of this incident, which occurred on March 8, 2018, at James’s elementary-school open house, was played before a jury in Texas last month. It is a larger symbol of how children such as James Younger have become pawns in the transgender debate.

The Younger case has gained much media attention, in the U.S. and beyond. The New York Times, the Washington Post, and the BBC all seem to cast the father as the villain, in particular for his refusal to agree that his child is transgender. Rolling Stone opines that the Younger story has become a “terrifying right-wing talking point.” Vox is worried about Republican state legislators’ trying to introduce bills prohibiting chemical and surgical interference with the sexual development of children who say they’re transgender, and “what [this] could mean for families nationwide” when “legislators want to have a say in whether Luna Younger should be allowed to socially transition.” For the Left, the Younger story is a tale of backwards attitudes victimizing a child.

In truth, it’s progressive attitudes that are victimizing the child, and James Younger is not an outlier. There are many more just like him, and some in even more dire straits. For years, the medical and legal establishments have been ignoring evidence and bending their standards to please transgender activists, some of whom are clinicians. There are three clinical approaches to helping children who exhibit symptoms of gender confusion. One involves a range of talk therapies and psychotherapies to address suspected underlying causes. A second, called “watchful waiting,” allows the child’s development to unfold as it will, which may mean that he chooses to transition later or not at all.

Then there is a third option — informed by an ideology according to which it is possible for a child to be “born in the wrong body.” In this option, clinical activists recommend a drastic response when a child expresses confusion about gender. First, parents should tell the child, however young, that he truly is the sex he identifies with. Second, parents should consider delaying his puberty through off-label uses of drugs that can have serious (and largely unstudied) side effects. Third, parents should consider giving their child the puberty experience of the opposite sex, through cross-sex hormonal injections and gels (which result in sterility). Finally, parents should consider greenlighting the surgical removal of their child’s reproductive organs.

Since there are no objective tests to confirm a transgender diagnosis, all of this is arbitrary and dependent on a child’s changeable feelings. To make aggressive treatment more acceptable, its advocates have come up with a media-friendly euphemism, “gender affirmation.” If it’s affirming, activists say, it’s also kindness, love, acceptance, and support. The opposite, trying to help a child feel more comfortable with his body, is a rejection: abuse, hatred, “transphobia,” or “conversion therapy” likely to lead to child suicide. This is a lie — a lie designed to obscure a critical truth: that neither a child, nor his parents on his behalf, can truly consent to experimental, life-altering, and irreversible treatments for which there is no evidentiary support.

Hours before the incident at James’s elementary-school open house, Georgulas had emailed her ex-husband, Younger, whose day it was to have custody of James and his fraternal twin, Jude. She had said that she would bring James to school as “Luna,” since that’s what everyone there knew him as. “I understand that you believe you are truly doing the best thing for your child,” Georgulas wrote. “But in the same way a little boy with his penis removed is still a little boy, a little girl who was born with a penis is still a little girl in her brain.”

In October 2016, the court had established a Standard Possession Order, in which it was decided that the boys would live with Georgulas but that Younger would have custody and access rights, especially on weekends. The order also gave Georgulas the “exclusive right,” after notifying Younger, to allow medical and surgical treatment “involving invasive procedures” as well as “psychiatric and psychological treatment” and education.

Georgulas claims that James chose the name “Luna” after communicating a desire to be a girl at a young age by showing a preference for female pronouns and Disney princesses. Younger insists that James’s transgender status is contrived, and he possesses a video of James at age three saying that “Mommy” told him he was a girl. He further believes that Georgulas is unhinged and intent on vengeance, disregarding James’s well-being.

In an email dated August 5, 2017, with the subject line “Heads Up,” Georgulas wrote to Younger to explain that “Luna, yes (I will refer to her that way, because that is what she wants to be called at my house), has decided to tell you she has a girl brain and a boy body and that she is transgender.” She explained that they had been reading I Am Jazz as well as My Princess Boy and that in these books, “although other people are occasionally mean or confused, the parents are affirming.”

During the trial this October, Younger was asking the court to appoint him sole managing conservator, which would give him executive rights to the boys’ medical and psychological care. Georgulas was asking it to restrict possession and access for Younger and enjoin him from treating James as a boy, but she was not asking to be sole managing conservator. Although the jury decided overwhelmingly against Younger, by eleven to one, having heard the recommendations of custody evaluator Benjamin Albritton, a psychologist, the judge decided not to grant Georgulas a request to be the single conservator.

Judge Kim Cooks decided that the parents would have joint rights on all medical and psychological decisions, increased Younger’s possession rights, and denied Georgulas’s petition to enjoin Younger from treating James as a boy. Cooks relied on the United States Constitution in her decision, specifically on the due-process rights “afforded by the 14th Amendment familial association, specifically parental rights or in this case a father’s rights.”

She stated that “it is a liberty interest for parents to have the autonomy to raise their children” and added that the state of Texas had no “compelling interest” to justify interference. Georgulas’s lawyers have moved for the recusal of Judge Cooks because she mentioned the case on Facebook.

Georgulas’s decision to “socially transition” James, which means treating him as a girl (as opposed to merely allowing him to dress like one), follows a new and experimental form of social-psychological treatment for the mental condition known as “gender dysphoria.” Looking ahead, James’s pediatrician indicated that James would have an evaluation at the GENECIS gender clinic when he was closer to the age of eight or nine and would “plan to see an Endo[crinologist] in 2–3 years for hormone suppression.” Albritton, the custody evaluator, noted in his report that studies suggest that once an individual is launched on this medical pathway, the gender dysphoria is more likely to persist, “especially in natal boys.”

The definition of “gender dysphoria” has long been in flux. Beginning in the latter half of the 20th century, adults (normally men) who experienced a strong desire to be the opposite sex or took measures to more closely resemble the opposite sex were known as “transsexuals.” Male-to-female transsexualism, especially as it related to sexuality and fetishes, was initially seen as a perversion, then a disorder. Now it’s an identity, covered under a much larger umbrella term, “transgenderism.” Transsexual inclination in children, defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders as “gender identity disorder” (1994) and now as “gender dysphoria” (2013), was rare and poorly understood, generally manifesting itself in the form of disassociation from one’s sex (in pre-pubertal children) and discomfort with one’s sexual development (at puberty, especially among peers).

Other than one Dutch study looking at pubertal suppression in adolescents that suggests “puberty blocker” hormones might contribute to the persistence of gender dysphoria, there are no studies or long-term follow-ups in which social transition prior to puberty has been clinically examined. But we do have a significant body of eleven papers that examine “desistance” (that is, children’s growing out of such feelings) in children whose dysphoria began when they were between three and twelve years of age, and these children were followed up with at a later date.

“Despite the differences in country, culture, decade, and follow-up length and method,” notes James Cantor, a Canadian psychologist with decades of clinical and research experience in treating transsexuals, “all the studies have come to a remarkably similar conclusion: Only very few trans-kids still want to transition by the time they are adults.” From these studies, conducted prior to the cultural mainstreaming of gender-identity theory, it consistently appears that 80 percent of gender-confused children psychologically realign with their biological sex by young adulthood or sooner when supported through their natural puberty with non-invasive therapies such as watchful waiting. Realignment was (and, among more cautious professionals, still is) considered the ideal outcome, since it is obviously easier for a child to change his thinking than to try to change his sex.

In the 1990s, the Dutch began to experiment with puberty blockers — which had originally been used to treat precocious (early) puberty — for very extreme cases of childhood gender-identity disorders. The idea was that an acutely gender-distressed child would benefit from gaining extra time to come to terms with his body before puberty brought additional distress. The researchers called this the “pause button.” But as the first step in the “gender affirmation” process, it amounts to more of a nuclear button. On the gender-affirmation model, clinicians have put children as young as twelve on sterilizing cross-sex hormones, removed the healthy breasts of girls as young as 13, and peeled and inverted the penises of boys as young as 15. Is it too much to wonder why?

Humans are a sexually dimorphic species. Females produce eggs and bear offspring, while males produce sperm and impregnate females. The existence of disorders of sexual development (or, more imprecisely and potentially offensively, of “intersex” persons), and the need for greater social understanding of them, in no way collapses this distinction.

In the 1950s, the relationship between the terms “sex” and “gender” (the latter of which applied chiefly to grammar) began to change as sexologists coined the phrase “gender identity” to denote the sex that one believed one was. In the 1960s, to explore this concept, psychologist John Money conducted a twin study in which a male baby, Bruce Reimer, with a damaged penis was raised as a girl, while his brother, Brian, was raised as a boy. Money instructed the parents to raise their children to believe that Bruce was really a girl called “Brenda.” For over a decade, the experiment was lauded as a milestone in sexology — to preserve the boys’ anonymity, it was called the “Joan/John” study — and its reported success was used as a precedent for countless surgeries on children with disorders of sex development. But, decades later, a follow-up revealed that the Reimer brothers had been deeply unhappy with their treatment by Money and Bruce had reverted to his male identity in his teens, taking the name “David.” After going public, David and his mother (whom he forgave, believing her to have been loving but misled) appeared on Oprah Winfrey’s talk show in 2000:

Mrs. Reimer: During the whole journey of trying to create a feminine being, there were doubts along the way. But I couldn’t afford to contemplate them because I couldn’t afford to be wrong. I couldn’t have faced the alternative.

Winfrey: And the alternative being what? That you’d made this horrible mistake?

Mrs. Reimer: Yes.

Winfrey: ’Cause then what could you do?

Mrs. Reimer: Right.

After a lifetime suffering from depression, the brothers — first Brian, then David — killed themselves. In a “tragic update,” printed in a revised edition of As Nature Made Him, an investigative book on the Reimer story, John Colapinto recalls the moment when David’s father called him to say that David had shot himself: “I cannot say it was a complete surprise.” As more journalists shared the true nature of Money’s experiment, and as more and more intersex victims of unnecessary medical interventions came forward, the medical profession revised its standards with regard to children with disorders of sex development (in particular those with genital irregularities) so as to leave these children’s fully functioning bodies alone. But what about gender-confused children?

Today, it takes a bold and distinguished person to state the obvious answer to that question. One such person is Dr. C. Alan Hopewell, the senior clinical neuropsychologist in the state of Texas, whose decades of expertise in treating children of James’s age led Younger to engage him as an expert witness.

At James’s age, children “can’t make rational decisions” and are “very easily influenced,” Hopewell stated in his September deposition for the trial. He also said that this “settled science,” pioneered by psychologist Jean Piaget, is “at the level of Galileo’s statement of how the Earth revolves around the sun.” While a child can express preferences — “Do I want the M&M or do I want the mushroom?” — a seven-year-old is incapable of decisions of the magnitude of trying to “change your sex,” which, at any rate, “you can’t do.”

Georgulas testified that she felt justified in socially transitioning James into Luna by her own experience as a pediatrician, by researching the medical literature on the subject, and by the support she has received online from similarly situated parents.

In July, her lawyer, Kim Meaders, made the following opening remarks at a hearing in a Texas district court:

This case is about a little six-year-old girl. It’s a little girl who knows she is a girl. It’s a girl who wears cute, frilly, girlie clothes. She plays with super girlie bears and dolls and toys. . . . [Her] self-portraits of herself show herself with big, huge, ginormous eyelashes and hair down to the floor. . . . And the father in this case wants boys. He has twins, and the reality is, Luna, at birth, was given the gender identity as a boy, but she completely and totally identifies as a girl now. 

But again, by all objective standards, and as acknowledged by the impartial court-appointed amicus attorney, it is “clear” that James Younger is not a girl but a boy. He is a little boy regardless of whether he knows he is a boy. A little boy with a penis — which is referred to by Georgulas herself in one email to Younger: “Luna has gotten a bugbite on the right side of her penis” — testes, a Y chromosome. He is a little boy regardless of how “ginormous” the eyelashes are in his “self-portrait” and irrespective of his wardrobe choices, however “cute” and “frilly.” Of course, the possibility exists that James is a little boy who fits the diagnostic criteria for gender dysphoria (more about that in a moment).

On October 17, observers in the courtroom reported seeing someone sitting by Georgulas’s attorneys, passing notes and advising counsel. She was Dr. Johanna Olson-Kennedy, the medical director of the largest transgender-youth clinic in the United States, one of four directors of a multi-million-dollar National Institutes of Health (i.e., taxpayer-funded) experimental study on early intervention in transgender youth, and one of the most prominent clinical activists in the United States.

It is difficult to say, exactly, how many transgender-youth clinics there are in the United States today. In 2006, there were none. But in 2014 the Human Rights Campaign, a gay and transgender lobby group, counted more than 40. It is possible, if not likely, that there are significantly more than that. Olson-Kennedy’s clinic in Los Angeles saw 80 young people, aged between four and 24, in 2009, and over 1,000 in 2019. The latter number comes from a Reuters report. By a crude estimate, then, there could be tens of thousands of young people being treated at such clinics. But we don’t know.

The Centers for Disease Control says that 2 percent of American high-school students (around 300,000 adolescents) identify as transgender. Does that mean gender dysphoria is on the rise? Not necessarily. One board-certified psychiatrist, a graduate of a top medical school with over 15 years’ experience treating adolescents, told me that the numbers seem “highly inflated.” This is partly because gender clinics, like many specialist clinics, are essentially businesses with an interest in selling a uniform diagnosis. In his own practice, he prefers to “talk big-picture first” and not take a child’s declared gender identity at face value.

“If a patient comes in and tells me, ‘I’m having a strong desire to be the opposite sex,’ my next question is why? What does that mean? What’s your understanding of being the opposite sex? Are you nervous about being your own sex? Do you have anxiety?” He also considers whether his patient might be on the autism spectrum, which is disproportionately common among those with gender dysphoria. Often, through talk therapy, something else comes out — for example, that a girl is petrified about her menstrual cycle, or a boy about having homosexual inclinations and being bullied by his peers. The psychiatrist says that social anxiety is an underlying factor in most of these cases.

In his deposition in the James Younger case, Dr. Hopewell stated that “you’re not going to cut off [healthy] body parts unless something’s wrong with your thinking.” But Dr. Olson-Kennedy — again, the head of the largest transgender-youth clinic in the United States and one of the leaders of a publicly funded NIH study — took a rather different view in her own deposition. Younger’s lawyer, Logan Odeneal, asked Olson-Kennedy whether it is safe or ethical to remove healthy breast tissue from adolescent girls as young as 13, as has been recommended at her clinic.

Odeneal: Well, if you remove the breasts from a young woman, she will never be able to lactate or to breastfeed an infant; is that correct? 

Olson-Kennedy: Well, I, I don’t advocate removal for breast tissue from young women. I advocate for chest reconstruction in young men.

Odeneal: Well haven’t you referred girls to have the chest surgery from your clinic?

Olson-Kennedy: They’re, they’re, they’re not girls. They’re not girls. They don’t identify as girls. So I have referred people who identify as transmasculine or as boys or young men for surgery, yes.

Odeneal: But do their birth certificates identify them as girls?

Olson-Kennedy: Sometimes, and sometimes they’ve had their gender marker changed on their birth certificate.

Odeneal: How many patients have you referred for the chest surgery? 

Olson-Kennedy: Probably about 200. 

When Odeneal asked whether the procedure involved the removal of “healthy” breast tissue, Olson-Kennedy explained that she takes “issue with the word ‘healthy’” since it’s not healthy “if it’s creating a lot of distress in their life.” Elsewhere, she told an audience, “If you want breasts at a later point in your life you can go and get them.”

The National Institutes of Health study on early intervention in transgender youth that Olson-Kennedy oversees along with three others involves multiple sites and hundreds of participants. In a talk at an activist-clinician conference in September of this year, she explained that the study was “observational” and didn’t have a control group (a group of participants receiving the standard, accepted treatment for the purposes of comparison). “When we first put this grant into the NIH five years ago, they came back with primary concern that we didn’t have an untreated control group. Yeah, so we’re not going to have an untreated control group, I’m warning you right now,” she said, prompting audience laughter.

Presumably, Olson-Kennedy’s reasoning for not having a control group is that it is unethical for a physician to treat (or not treat) a patient in a way he considers not to be in the patient’s best interests. Olson-Kennedy told Younger’s lawyer, Odeneal, that the reason this study does not have a control group is “because not treating people with gender dysphoria who are seeking treatment is unethical practice.” Does this mean she considers treatments other than gender affirmation “not treating” patients? If so, to repeat, the evidence for gender affirmation is unclear and unconvincing, while the majority of children who have been managed under a watchful-waiting or talk-therapy strategy have apparently improved. The latter is the clinical standard for which there is the most substantial, albeit imperfect, evidence of effectiveness and safety. I have to speculate here because, although Olson-Kennedy agreed to an interview last summer, she twice failed to dial in at the appointed time to the conference number her office had emailed me. Her office has since gone dark.

Ordinarily, when investigating complicated and life-altering treatments emerging in medicine (and especially pediatrics), investigators must follow a series of steps: First, the researchers must demonstrate to their institution’s Institutional Review Board that their treatment is credible and ethical. Second, the patients and parents of children must sign an informed-consent paper, with emphasis on the word “informed,” especially if the treatment is experimental. Third, the group of patients receiving the treatment must be paired with a control group that is treated in more standard fashion.

But why is the NIH facilitating this study on early intervention among trans youth in the first place? What do they hope to learn? What kind of information about risks has been given to parents and children? These are some of the questions to which I might have found answers if the relevant documents, which a concerned medical doctor obtained through the Freedom of Information Act, had not been so heavily redacted, most notably in the sections related to informed consent. Does the NIH, or do those in charge of this study, have something to hide? In a recent “listening session” held by the NIH’s Sexual and Gender Minority Research Office, one activist inquired into whether it might be possible for the NIH to extend the study “for another five years so that we can get even more longitudinal data,” which would be “helpful” to show courts “that the affirming parent is actually acting in the best interest of the child,” since there has been a recent “uptick in custody disputes involving transgender youth.”

A study published in 2017 in the Journal of Sexual Medicine entitled “Age Is Just a Number” endeavored to investigate “WPATH-affiliated surgeons’ views, experiences, and attitudes toward performing vaginoplasty,” i.e., castration, inversion of the penis, and dilation of a cavity to form a pseudo-vaginal canal, “on transgender minors in the United States.” (WPATH is the World Professional Association for Transgender Health.) Of 20 surgeons who were interviewed, eleven reported having done the procedure “1 to 20” times on children under age 18. The youngest patient was 15.

One surgeon gave an indication as to why this might be a bad idea. He or she described the new clinical landscape as a “new Wild West” where “a bunch of solo practitioners, basically cowboys or cowgirls who kind of build their little house, advertise and suck people in.” In the U.K., the Times of London has covered a whistleblower scandal at Britain’s main clinic for gender-confused youth, from which multiple clinicians have resigned, citing dangerous, experimental, and inadequate care.

The authors of the Journal of Sexual Medicine study also remarked on “the legal impossibility to obtain informed consent from the underage patient.” But that isn’t the only problem with relying on the feelings of minors.

Many of these underage patients are already damaged and vulnerable. At the Gender Infinity Conference (an “Affirming Space to Empower Gender Diverse Individuals”) in 2015 in Texas, Olson-Kennedy told an audience that “a not-insignificant” number of young people at her clinic “have actually done sex economy, sex work, for a place to live or something to eat,” and that “a lot experience homelessness, precarious housing, and have been in foster care.” This is consistent with her published research. A study from 2015 included transgender youths who had prostituted themselves, been homeless, and abused drugs; a follow-up study in 2018 failed to account for 41 percent of the participants, meaning that no one knows what has happened to them.

Perhaps having worked with prostitutes and homeless and drug-using youth has made Olson-Kennedy sensitive to the importance of mental-health screening for patients before they undertake life-altering hormone interventions or surgery. But on Facebook, she once wrote that the “uptick in insurance companies asking for mental health NOTES and signed consents prior to covering blockers [is] ridiculous!!” Still, she is considered a leader in the field. Her method is now finding popularity in the U.K. She was recently brought there on a teaching fellowship by the University of Bristol and invited by the British gender-youth charity Mermaids, which promotes child sex-change treatments, to partake in a Facebook livestream event titled “If Your Child Thinks They’re Transgender, They Probably Are.” This event also featured Helen Webberley, a British doctor who, the Times of London reported, was criminally convicted “for operating an unlicensed clinic” that “charged between £75 and £150 an hour to prescribe . . . sex-change hormones, which cause irreversible bodily changes and permanent loss of sexual function.” Her husband, Mike Webberley, also a doctor, was similarly suspended and banned from practicing medicine in the U.K. after a tribunal found that “his work for three young trans patients fell below the standards of care expected of a registered doctor.” The Webberleys have now moved to Spain, where their private clinic “will continue to dispense drugs online from its new base in Malaga,” the Times of London reports.

In response to the James Younger case, the Pediatric Endocrine Society, which has a membership of 1,300 doctors, distributed a statement “against public discourse that risks the well-being of transgender and gender diverse youth and their families.” It wrote that “this concerns a 7-year-old transgender girl in Texas whose mother (a pediatrician) is supportive of her gender identity but whose father is not.” The statement continued:

The parents are involved in a custody battle that has drawn significant media attention. The father has reached out to conservative groups and lawmakers who are spreading misinformation about care of gender variant youth and are threatening to introduce legislation prohibiting the use of puberty blockers in transgender patients.

This is simply ill-disguised advocacy, but it is nonetheless of a piece with a recent policy statement on “transgender and gender diverse children and adolescents” from the American Academy of Pediatrics. Fewer than 30 committee members at the AAP, which represents 67,000 doctors, approved the statement, written by a doctor with (according to the PubMed database) no published papers in gender dysphoria. It favors “affirming” any “child’s self-expressed identity,” disparages watchful waiting, and suggests that therapies designed to reconcile a child with his or her body are “outside the mainstream of traditional medical practice.”

 In a rebuttal that has completed peer review and will appear in the Journal of Sex and Marital Therapy, James Cantor, the Canadian clinical psychologist, who describes himself as “openly gay” and politically liberal (not that it ought to be relevant), explains:

Although almost all clinics and professional associations in the world use what’s called the watchful waiting approach to helping gender diverse (GD) children, the AAP statement instead rejected that consensus, endorsing gender affirmation as the only acceptable approach. Remarkably, not only did the AAP statement fail to include any of the actual outcomes literature on such cases, but it also misrepresented the contents of its citations, which repeatedly said the very opposite of what AAP attributed to them.

Cantor told me that the AAP policy statement could be interpreted as “malpractice writ large” and that it “calls into question their entire decision-making process.” Kenneth Zucker, a clinical psychologist and expert in youth gender dysphoria whose work is among the most cited in the field and who has over 40 years of clinical and research experience, told me that the AAP’s advice is “so fundamentally flawed that one wouldn’t even know . . . where to start.”

How can this be possible? What or who is influencing these professional committees that advise and represent hundreds of thousands of doctors in the United States? During the James Younger trial, this question was answered during the deposition of Dr. Hopewell by Georgulas’s lawyer. The lawyer, Kim Meaders, asks whether Hopewell is familiar with the American Academy of Pediatrics’ stance on “supporting and treating transgender individuals” and that of the American Psychological Association, which also favors “gender affirmation.” He says that he is familiar but disagrees.

Meaders then asks how he can possibly disagree if he is a fellow of the American Psychological Association. Hopewell explains that, while “most of the real doctors are out earning a living working,” many of those who run the boards do so for political reasons: “Just because an organization takes a stand really doesn’t have anything to do with either science or the membership of the body itself.”

Besides subjecting individual children to an ordeal, the gender-affirmation approach may be contributing to a social pathology. Lisa Littman, an assistant professor at Brown University, wrote a 2018 paper in the science journal PLOS ONE that reported the new phenomenon of teen girls’ suddenly identifying as boys — despite having no prior history of gender dysphoria — as a possible “peer and social contagion.”

The pertinence of Littman’s observation is shown in the number of children reporting gender dysphoria to Britain’s largest gender youth clinic, a public institution. It is now around 2,500 a year. In 2009, it was fewer than 100 a year. There has been a 42-fold increase in the number of females at the clinic in the last decade.

A mother is now taking legal action against the clinic in an attempt to prevent it from giving puberty-blocking drugs to her 15-year-old autistic daughter. Her claim is that the clinic misinforms families and puts highly vulnerable children at risk. A former therapist at the clinic, who resigned for ethical reasons, has become a whistleblower, saying that staff in the clinic were under “huge pressure” to rush children into medical treatment after substandard evaluation, according to the Times of London.

Sky News reported that “hundreds of young transgender people are seeking help to return to their original sex.” The report focused on a woman, Charlie Evans, 28, who was born female but identified as a man for nearly ten years before returning to her original identity, a process that is called “detransitioning.” Similar stories of regret are receiving significant media attention in the U.K. Marcus Evans, the former governor of the British National Health Service’s London-based adolescent and adult clinical services, which oversees the largest gender youth clinic in the country, warned that “the treatment of gender-dysphoric youth has become highly politicised and, in many ways, operates outside good medical practice.” Evans handed in his resignation after 35 years, citing the gender clinic’s “woeful” care and saying it was “not fit for purpose.”

As with the clinicians who resigned from the London clinic, Lisa Littman, who was first to research the social contagion in teen girls, recently told me of her serious concerns about whether those being diagnosed with gender dysphoria actually have an underlying issue such as “trauma, sexual assault, homophobia, homophobic bullying, misogyny, or a mental-health condition.”

But both inside and outside the profession, clinical activists are ruthless in pursuit of their aims, and they accept no criticism. At the website of Psychology Today, a Harvard psychiatrist and medical researcher, Jack Turban, recently published a summary of some research that he said showed a link between “conversion therapy” — by which he means therapies geared at helping a person psychologically accept his biological sex — and suicide. Medical professionals posted their critiques of his work, suggesting the studies were fundamentally and dangerously flawed in their methodology and conclusions, but Psychology Today appears to have deleted their comments.

Sharon Dunski-Vermont, a pediatrician and member of the clinical advocacy group USPATH (U.S. Professional Association for Transgender Health) and the American Academy of Pediatrics who has written an op-ed for the Washington Post about her female-to-male transgender teenager, has posted misinformation elsewhere. In a Facebook group with over 8,000 members for parents transitioning their children, one parent expressed concerns about a report that an eight-year-old had been included in the NIH study’s cross-sex-hormone cohort. “NONE of this is true,” Dunski-Vermont stated. “We start Puberty blockers in early puberty, which at times could be 8-9 years old but NEVER cross gender hormones.”

A group administrator then disabled further comments, offering the explanation that “this story falls into the realm of flat-earthers and holocaust-deniers and is triggering to many.” However, a 2017 progress report for the NIH study, which a doctor obtained through a freedom-of-information request, did state that “the minimum age for the cross-sex hormone cohort inclusion criteria was decreased from 13 to 8 to ensure that a potential participant . . . could be eligible for cross-sex hormones.” In such a new and exploratory field of medicine, certainty and censorship are a dangerous combination.

To give an idea of the vulnerability of the children in this Facebook group, consider that one parent posted a picture of a teen girl with Down syndrome who appears to have had her breasts removed. The parent asks to connect with the parents of other Down, trans children. Another picture shows a boy, seeming no older than six years old and wearing a dress, with his arm in a cast. His mother explains that her ex-husband (who was ambivalent about the child’s gender transition) “broke her arm.” Another mother describes in detail how her ex-partner sexually abused her twelve-year-old daughter, who now thinks she is a transgender boy. The mother writes, “My question is (and I don’t know if this is allowed), has anyone else been through this? I feel like his dysphoria may have been amplified” by the sexual abuse.

James Younger was first diagnosed as having gender dysphoria by his pediatrician. The diagnosis was confirmed by a “solution-focused therapist” serving the LGBT community at Rainbow Counseling, in Texas, and by the GENECIS gender clinic, which specializes in medical interventions for gender-confused youth. In his psychological assessment of Jeffrey Younger, Albritton, the custody evaluator, noted that James showed no signs of distress when dressed as a boy or as a girl.

Distress is one of the diagnostic criteria for gender dysphoria. Yet in his assessment of James, Albritton noted that while James “is consistently described and observed as playful, kind and creative,” he is “clearly at risk for social and psychological difficulties and challenges given his gender dysphoria.” In an interview, James told Albritton that “he is a boy at his father’s house and a girl at his mother’s house.” His mother brought him to interviews with Albritton dressed in high heels and stick-on earrings. His father brought him dressed in boy’s clothes and “appropriately groomed.”

Strikingly, however, Albritton’s takeaway was that “it is difficult, if not impossible, to entirely ferret out pressure from his father to conform with male ideals.” He noted that Jeffrey Younger’s profile fits that of someone experiencing a “disconnection from reality,” as well as “psychotic symptoms of paranoia.” He reported that Anne Georgulas “presented as a friendly, outgoing woman” who “appears to be aware of her children’s needs and attempts to advance appropriate development.” Albritton recommended that James be allowed to continue socially transitioning.

Though the jury was swayed by such arguments, Judge Cooks ultimately decided that both parents were fit to parent and they should work out James’s medical care between them. But the deeper issue is that it’s impossible to sensibly adjudicate such cases when misinformation is being enshrined systematically in the medical and legal establishments and the mainstream media are failing so dismally to report on it accurately.

I am currently in contact with parents across America and Europe who face circumstances similar to Jeffrey Younger’s and whose extensive documentation I have reviewed. One father in Minnesota has been denied a say in his ten-year-old autistic son’s medical care. This boy’s mother is taking him to a gender therapist who has told the boy that he is not only a transgender female but a lesbian.

The Kelsey Coalition, a new nonpartisan grassroots organization, has collected testimony from parents of children identifying as transgender who have been harmed. Some of these parents are in custody battles in closed-door trials, such as two gay parents who are having a fight over a child the same age as James Younger and in which the contested claims are almost identical. Others have had their children placed in foster care because they refused to consent to medicalizing their child’s treatment. Many parents are afraid to talk to the media for fear of being reported to child-protective services or held in contempt of court gag orders.

And so it goes. In a better world, James Younger wouldn’t be the object of a tug-of-war between two parents. But it is beyond cynicism to accept that the legal and medical establishments may forcibly try to change a child’s sex, against his interests, without the consent of both his parents, and in spite of the scientific evidence.

Editor’s Note: This article has been updated since its publication in print.

Madeleine Kearns is a William F. Buckley Fellow in Political Journalism at the National Review Institute. She is from Glasgow, Scotland, and is a trained singer.

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