The National Health Service of England just announced that the infamous Tavistock clinic, which promotes the transition of children under the gender-affirming model, is going to be shut down and replaced with regional centers at children’s hospitals that take a therapy-first approach. 

This follows similar decisions in Sweden and Finland implemented after exhaustive research found low benefits associated with high-risk medical transitions in children.

Unfortunately, this is the opposite of what we see in the United States, as gender-affirming clinics continue to proliferate and politicians double down on the flawed and dangerous gender-affirming model.

Our nation is undergoing a cultural convulsion centered around the false belief that people can change sexes. The assertion that you can change sex and the accompanying practice of altering your body to look like the other sex is an unchallengeable set of beliefs called “trans rights.” 

And anyone questioning or raising concerns about non-medically necessary procedures as radical as double mastectomies for female adolescents or orchiectomies — testicle removal for male teens — is called a “transphobe.”

Adults making informed choices can and should do as they please — including transitioning — i.e., living outwardly, and without discrimination, as though you are the opposite sex. But children are now being rushed through hormonal and surgical procedures to make their outer bodies match their inchoate, and often unexplored, inner feelings. 

The irreversible processes are sometimes happening without a single adult in their lives suggesting there might be other pathways to quiet the gender dysphoria or achieve the goals their youthful selves have not yet fully articulated. The rush toward irreversible procedures that can and do leave children neutered and sterile is what so many disingenuously call “gender affirming care.” 

It certainly affirms extreme activists and some trans people who want their world view unchallenged, but it betrays children and their families who deserve better, more thoughtful, nuanced medical care.  

One of the most severe consequences of our polarized, hyper-partisan political environment is the inability to pass meaningful legislation in Congress. Legislators can’t pass laws on these topics if they can’t even talk about these topics — and very few want to have nuanced conversations about transgenderism.

What should we be discussing? Clinicians are currently prescribing puberty blockers to thousands of American children based on their own self-diagnosis and the gender-affirming care model that says “agree with the patient and don’t ask too many questions.”  

These medications, more formally known as gonadotropin-releasing hormone agonists, are FDA approved for precocious puberty, or when the onset of puberty occurs much earlier than expected. When puberty blockers are prescribed to delay puberty in transgender children, that is considered off-label use. 

While off-label use is common in medicine, there are precautions that regulatory bodies can and should take to protect children from potential harms. As recently as this week, in a step in the right direction, the FDA added brain swelling and the possibility of permanent vision loss as potential risks associated with puberty blockers.

But the FDA should do more, and has in the past. In 2000, Congress held public hearings to review the safety and side effects of the drug Isotretinoin — most known by the brand name Accutane. Used to treat acne, Accutane is highly effective, but has severe side effects including depression and fetal birth defects. The issues with Accutane received increased media spotlight when, among other things, a sitting U.S. senator’s son committed suicide after using the drug. 

After public hearings the FDA developed and now regulates a comprehensive informed-consent system called iPledge that requires prescribers, pharmacies, and patients who want to access the drug to enroll and participate. It is an effective system because it was developed after public debate, is data driven, and provides robust informed consent. 

The families of dysphoric children deserve public hearings regarding the administration of puberty blockers, but politicians avoid the topic because it is a landmine. Democrats do not want to offend a base who asserts that merely mentioning the biological differences between women and men identifying as women is transphobia, and many Republicans see the issue as a way to beat up on Democrats.

It is time to follow the lead of England, Sweden, and Finland and govern the treatment of gender dysphoric children based on data and honest analysis and not ideological conformity.