In recent years, the medical establishment has increasingly promoted “gender-affirming care” as the solution for children experiencing gender distress. Yet growing evidence suggests we should approach these interventions with far greater caution than is currently the norm. The analysis examines the scientific evidence without addressing biblical perspectives, focusing instead on medical research, developmental psychology, and ethical considerations that should concern any parent or healthcare provider.

 

WHAT EXACTLY IS “GENDER-AFFIRMING CARE”?

Gender-affirming treatments for minors typically progress through several stages:

1. Social transition: Changes in name, pronouns, clothing, and facilities access
2. Puberty blockers: Medications that suppress natural hormonal development
3. Cross-sex hormones: Testosterone for females or oestrogen for males
4. Surgeries: Including mastectomies, genital surgeries, and other body modifications

Major medical associations have endorsed these interventions, often describing them as “life-saving” and “medically necessary.” Yet medical consensus is shifting rapidly as more evidence emerges, and parents are increasingly caught between institutional pressure and growing scientific concerns.

 

THE EVIDENCE GAP IN GENDER MEDICINE

Despite widespread implementation, gender interventions for minors rest on a surprisingly weak evidence base. This isn’t merely a contrary opinion—it’s the conclusion of systematic reviews from multiple countries.

The UK’s Cass Review: Dr Hilary Cass—a paediatrician appointed by England’s National Health Service—led an independent review that found the evidence for puberty blockers and hormones “remarkably weak.” Her comprehensive analysis concluded these medical interventions were based more on ideological commitments than robust science. Specifically, the review highlighted:

• The absence of controlled studies demonstrating improved mental health outcomes
• Inadequate research on how these interventions affect neurological development
• Insufficient data tracking long-term physical complications
• Evidence that clinicians felt unable to thoroughly assess patients before intervention due to political pressure
• Troubling indications that medical services had been “predominantly affirmative” rather than exploratory in their approach

Dr. Cass’s conclusion was unambiguous: “Existing international evidence is overwhelmingly focused on the short-term outcomes of medical treatment, with a lack of attention to the long-term.”

Sweden and Finland’s Evidence-Based Reversals: Both countries—known for progressive healthcare policies—have drastically restricted medical interventions for minors with gender dysphoria, following systematic evidence reviews.

Finland’s Council for Choices in Health Care concluded “there is no scientific evidence that gender-affirming treatment would be medically necessary or could improve a minor’s mental health in the long term.” Their comprehensive analysis led to prioritising psychological interventions, rather than medical ones.

Similarly, Sweden’s National Board of Health and Welfare determined “the risks of puberty suppressing treatment… outweigh the possible benefits” and restricted such treatments to exceptional research settings. Their review specifically raised concerns about:

• Bone density implications that may result in lifelong fragility
• The unknown impact on neural development during critical adolescent brain growth
• Irreversible effects on sexual function and fertility
• Evidence that many cases of adolescent-onset dysphoria resolve naturally during normal development

Longitudinal Studies and Methodological Problems: The much-cited “Dutch protocol”—the original research supporting puberty suppression—has significant limitations that have rarely been acknowledged:

• It was conducted on a carefully selected group of early-onset, persistent cases—not the demographic now predominantly seeking care
• It excluded patients with significant mental health comorbidities—who comprise the majority of current patients
• It involved intensive psychological screening and support rarely replicated in current practice
• Even within this carefully selected group, outcomes showed minimal improvement in key mental health metrics

More recent studies suffer from methodological issues that would be considered unacceptable in other medical fields:

• High participant dropout rates (sometimes exceeding 50%)
• Reliance on self-reporting rather than objective measures
• Short follow-up periods (typically 1-2 years)
• Lack of control groups
• Failure to account for confounding variables

 

DEVELOPMENTAL SCIENCE RAISES RED FLAGS

Neurological research on adolescent development raises serious questions about children’s capacity to consent to life-altering medical interventions.

Adolescent Brain Development: The prefrontal cortex—responsible for weighing long-term consequences, risk assessment, and impulse control—continues to develop well into the mid-20s. This neurological reality means adolescents:

• Show increased sensitivity to social rewards and peer influence
• Demonstrate reduced ability to evaluate long-term implications
• Are more likely to make decisions based on immediate emotional relief
• Have difficulty fully comprehending irreversible consequences

The Phenomenon of Desistence: Research consistently shows 60-90% of children with gender dysphoria will reconcile with their biological sex if allowed to go through natural puberty. This “desistence” pattern was widely acknowledged in medical literature until recently. Key findings include:

• Childhood-onset gender dysphoria typically resolves during puberty without intervention
• Many children later identify as gay, lesbian, or bisexual adults
• Social affirmation in childhood appears to reduce the likelihood of natural resolution
• Following social transition with puberty suppression creates a “locked-in” pathway where nearly 100% proceed to cross-sex hormones

 

THE CONCERNING RISE IN RAPID-ONSET GENDER DYSPHORIA

A dramatic demographic shift has occurred in the patient population:

Historically, patients were predominantly male, early childhood onset cases, and without significant psychiatric comorbidities

Current patients, however, are increasingly:

• Female (up to 70% in many clinics)
• Adolescent onset cases
• With significant pre-existing mental health conditions
• Showing patterns of social contagion and cluster outbreaks

This phenomenon, termed Rapid-Onset Gender Dysphoria (ROGD), was first documented by Dr Lisa Littman, whose research identified patterns strikingly similar to other peer-influenced conditions like eating disorders. Her findings indicate social and environmental factors—including social media influence, peer group dynamics, and psychological vulnerability—play significant roles in the current surge of adolescent gender distress.

 

EXAMINING CRITICAL CLAIMS

The Suicide Narrative: Perhaps most concerning is the frequent claim that affirming interventions prevent suicide. The powerful assertion has pushed many desperate parents to consent to treatments they’d otherwise question. The evidence, however, no longer supports the narrative:

• The often-cited studies compare suicidality between supported and unsupported trans-identifying youth, not between medically treated and non-medically treated individuals
• Studies fail to control for pre-existing mental health conditions that independently increase suicide risk
• Methodological issues include self-selection bias and reliance on self-reporting
• No long-term studies show reduced completed suicide rates following medical intervention

Dr Michael Biggs, Professor of Sociology at Oxford University, conducted a comprehensive review of the evidence and concluded: “There is no evidence that puberty blockers prevent suicidality. On the contrary, the evidence suggests that they may increase mental health problems.”

The “Reversibility” Myth: Puberty blockers are frequently described as providing a “pause button” with fully reversible effects. Yet emerging research challenges such characterisation:

• Studies show impacts on bone density that may not fully recover, potentially leading to lifelong osteoporosis risk
• Animal studies indicate potential effects on cognitive development, as sex hormones play crucial roles in brain maturation
• Questions remain about impacts on social-emotional development during a critical period when peers are developing sexual identity
• Evidence suggests disruptions to the development of neural pathways involved in decision-making and risk assessment
• Nearly all children who start puberty blockers proceed to cross-sex hormones, suggesting these drugs may solidify rather than merely pause identity development

Medical Necessity vs. Experimental Treatment: Though characterised as “standard care,” most gender interventions remain experimental:

• Most medications lack FDA approval for treating gender dysphoria
• Long-term studies beyond a few years are notably absent
• Many interventions bypass normal clinical trial processes
• Treatment protocols vary widely between practitioners
• Rising medical malpractice cases indicate emerging concerns about informed consent

 

CONCLUSION: STANDING FIRM FOR OUR CHILDREN’S WELLBEING

The pressure on parents to immediately affirm and medically treat childhood gender distress is intense. Medical institutions, school systems, and sometimes even child protection services create an environment where even questioning the evidence is portrayed as harmful.

Yet standing firm against the pressure of the medical establishment’s lies may be the most protective stance parents can take. Children experiencing gender distress deserve compassionate care based on sound evidence, not ideologically driven experimentation. Parents who resist rushing into irreversible interventions and instead seek comprehensive psychological support aren’t denying their children appropriate care—they’re protecting them from potential lifelong medical complications based on treatments with a remarkably weak evidence base.

 

GENDER-AFFIRMING CARE: RELATED FAQs

How has policy on gender-affirming care begun to shift internationally? Concerns over the evidence are triggering policy reversals worldwide. Sample these:

• United Kingdom: Following the Cass Review, the NHS has severely restricted puberty blockers outside of clinical trials
• Sweden: Treatments have been restricted to exceptional cases in research settings
• Finland: Psychological care is to be prioritised over medical interventions
• France: The National Academy of Medicine has called for “great medical caution” and for prioritising psychological support
• Norway: The Healthcare Investigation Board found treatments lack evidence and raised “major ethical dilemmas”
• Denmark: Conducting a systematic review and limiting medical interventions pending results
• Australia and New Zealand: Professional organisations have called for greater caution and more rigorous assessment

What’s the best way forward? Based on the latest evidence, what are some precautions parents must take? Parents with a child in gender distress deserve accurate information and ethical care options. Evidence-based approaches should include:

• Thorough Assessment: This must, in turn, include comprehensive psychological evaluation, exploration of potential contributing factors (trauma, autism spectrum conditions, social influences), assessment of comorbid conditions (anxiety, depression, eating disorders) and developmentally appropriate consideration of the child’s decision-making capacity
• Therapeutic Support: Evidence-based psychotherapy must be provided, addressing underlying issues, family therapy to improve communication and support, treatment for other mental health conditions, and exploration of identity questions in a non-directive environment.
• Cautious Approach to Irreversible Interventions: Most cases resolve naturally with appropriate psychological support. This realisation helps avoid social transitions that can increase persistence, and to defer medical interventions until adulthood when decision-making capacity is mature. At every stage, full disclosure of the limited evidence base and potential long-term risks must be made mandatory.

 

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