US ‘Most Permissive’ for Children’s Gender Transition While Europe Pulls Back, Study Shows


The United States is the “most permissive country” for legal and medical gender transition of children, according to a new study.

The report, released on Monday by Do No Harm, a group that seeks to insulate the health care profession from “radical, diverse, and discriminatory ideology,” compared the United States with 11 Northern and Western European countries on metrics including legal requirements to change gender; provisions for medical transition; the minimum age for puberty blockers and cross-sex hormones; and the number of youth gender clinics.

“In a sharp departure from the gender affirmation model employed in the United States, these countries now discourage automatic deference to a child’s self-declarations on the grounds that the risks outweigh the benefits, while also calling for months-long psychotherapy sessions to address co-occurring mental health problems,” the report states. “Notably, in the United Kingdom, the Cass Review attributed the lack of safeguards for children at the largest pediatric gender center to the ‘affirmative model,’ which ‘originated in the USA.’”

Last July, the UK’s National Health Service (NHS) announced that it would close its only gender identity clinic for children, the Tavistock Clinic, in 2023. The NHS made the decision based on an official report—the Cass Review (pdf), conducted by top British pediatrician and past president of the Royal College of Pediatrics and Child Health, Dr. Hilary Cass—that cited safety issues and concerns over long-term effects.

As a result, the NHS said it would move young people who believe they had gender dysphoria into regional centers, which would take a more “holistic” approach with mental health support.

In November 2022, the World Professional Association of Transgender Health (WPATH) said the Cass Review had “serious flaws.”

Health authorities in Sweden updated their guidelines for young people with gender dysphoria by advising against puberty blockers, surgery, and sex-change hormones before adulthood, a departure from WPATH’s recommendation to provide affirmation and medical intervention as the first line of treatment.

In Finland, adolescents experiencing gender dysphoria were allowed to access puberty blockers and hormones until 2020, when the country’s national health care council changed how it dealt with the matter through a new guideline that recommended identity exploration and mental health treatment.

‘Inflection Point in the United States’

Andrew Brown, associate vice president of policy at the non-profit Texas Public Policy Foundation, published a report (pdf) in June 2022 similar to the new study. He described the situation with a hiking analogy. “The U.S. were hikers, and then we were seeing England, Finland, Sweden, all these other countries running away, saying, ‘No, we went down further; that’s not a good path to go down,’” he told The Epoch Times.

“And so we’re at an inflection point in the United States to determine: are we going to go down this path that other countries are telling us not to go down, or are we going to heed their advice and stop providing these medicated these experimental treatments to kids?”

Dr. Michelle Cretella, executive director of the American College of Pediatricians, said she had been warning parents about “transgender ideology” since 2016. Cretella worked for 15 years as a pediatrician specializing in behavioral health.

“Many European countries have only a single gender clinic for children as opposed to the United States, which has at least 80 pediatric gender clinics and allows independent physicians and nurse practitioners to dispense puberty blockers and cross-sex hormones,” she told The Epoch Times. “It is much easier to investigate and obtain data on benefits or harm from a single centralized clinic,” she said, explaining why European countries are taking precautions on medical procedures for gender transition.

“The myth that sex and gender are both social constructs has become ubiquitous across American public institutions, including within our academic, medical, and mental health industries, to the point that this ideological myth trumps objective evidence of potential and actual irreversible harm to children,” she said, adding, “I believe that the vast majority of lay and professional Americans know sex is innate and immutable from conception to death, but remain silent for fear of being canceled or worse.”

Brown said his organization was working with state representatives to pass new legislation to “provide common sense protections for kids so that they’re not subjected to medical experimentation in the state of Texas.”

“The American people need to understand how radical the United States has become regarding gender ideology,” Dr. Stanley Goldfarb, board chair of Do No Harm, told The Epoch Times in an emailed statement. “Our study documents the concerns expressed by many European nations about caring for children with gender dysphoria. We show how the concept of ‘gender-affirming care’ in the United States is harming many children.”

The Epoch Times has contacted WPATH for comment.

Terri Wu is a Washington-based freelance reporter for The Epoch Times covering education and China-related issues. Send tips to terri.wu@epochtimes.com.



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