Medical Experts, Not Activists, Must Lead Discussion of Puberty Blockers

The narrative that the use of puberty blockers in children struggling with gender dysphoria is "safe" and "reversible" is crumbling fast. While concerns associated with the drugs' use are not new, they have been largely sidelined at the behest of ideologues who claim that any scrutiny of the evidence endangers vulnerable youth.

But recent investigative articles in the The New York Times and Reuters questioning the approach championed in progressive circles would suggest that scientific integrity is beginning to outweigh partisan allegiances.

Puberty blockers suppress estrogen and testosterone, hormones critical to children's physical development. Little is known about the long-term implications of these powerful drugs because of a lack of research on the topic, but existing studies show that puberty blockers negatively impact bone density (increasing the likelihood of osteoporosis) and brain development during adolescence.

Concerningly, the vast majority of children—as many as 98 percent—who take puberty blockers proceed to take cross-sex hormones, which almost invariably carry life-long consequences that include sterilization. Far from providing a "pause" to consider options, the use of puberty blockers appears to catalyze more permanent procedures.

While the use of puberty blockers started as an experimental treatment for gender dysphoria in Amsterdam in the 1990s, activists pushed for its widespread adoption and soon exported the practice to the United States. Despite a lack of evidence supporting that Dutch experiment, early and easy access to puberty blockers quickly became unquestioned medical dogma, both here and abroad.

But in recent years, international concern has grown about the dramatic increase in the use of puberty blockers. The national health services in Sweden, Finland, the United Kingdom, and France have all moved to significantly restrict their use. These countries emphasize that psychological treatment needs to be at the forefront of caring for these youth, who frequently suffer other psychiatric conditions.

The American medical community has lagged behind its European peers on this issue. Earlier this year, U.S. Assistant Secretary of Health Rachel Levine belittled concerns about the hormone treatments by saying there was "no argument" about "gender affirming care" among medical professionals. And the Biden administration went as far as to say any guardrails on children's access to puberty blockers would violate federal civil rights law. But this blinkered position seems to be increasingly untenable as a growing number of prominent voices evaluate the evidence.

In addition to the recent investigative pieces, prominent gender therapists Drs. Laura Edwards-Leeper and Erica Anderson have been outspoken in their view that children are receiving puberty blockers too quickly—and without any careful psychotherapy. These recognized pioneers in the field have not minced words: the American medical establishment is failing children.

There is also a growing movement of "detransitioners," or individuals who have come to accept their biological sex after undergoing hormone treatments or surgeries. Many of them are speaking out about their experiences of being rushed onto powerful drugs without any understanding of the consequences, and some have commenced lawsuits against the medical providers who were responsible for their care.

Despite these developments, many school districts have adopted the activist line that the only way to support children with gender dysphoria is to adopt an "affirmative" response that immediately puts a child onto a treatment pathway that ends with medical intervention. Many schools' policies now allow school officials to change students' names and pronouns at school (effecting "social transition") without the knowledge or consent of their parents. The Biden administration's recent attempt to rewrite Title IX further imperils parental rights by endorsing this secretive approach.

Dr. Stephen Levine, a world-renowned expert in the field, has outlined the concerns with such policies in a report recently submitted in an Alliance Defending Freedom case challenging one such school policy in Harrisonburg, Virginia. As Dr. Levine explains, while most children who experience discomfort with their sex naturally "desist" (or achieve comfort) over time, "social transition" starts a child on a conveyor-belt path that almost inevitably leads to the administration of puberty blockers and other medical intervention.

Schools that have enacted these radical policies should take a hard look at the very serious harms that children are exposed to in pursuit of an "affirmative" approach. Simply deriding those who express concerns does no favors to the children involved and can result in irreversible damage. It's time to ensure that medical experts, not activists, are leading the conversation.

Kate Anderson is senior counsel with Alliance Defending Freedom (@ADFLegal) and leads its Center for Parental Rights.

The views expressed in this article are the writer's own.