". . . and having done all . . . stand firm." Eph. 6:13


Gender Dysphoria Is About Confusion. So Is Its Latest Claim for Disability Status.

December 19, 2023

Many individuals who underwent gender-transition procedures are now warning others against using puberty blockers, cross-sex hormones, and surgery.

Despite these warnings and the solid empirical evidence demonstrating the harms of “gender-affirming care,” there are those who insist upon mislabeling the psychological issue of gender dysphoria as a physiological disability that requires physiological intervention. One of the latest twists in this unfolding story occurred in Missouri, one of 22 states whose legislators have enacted laws to protect children from irreversible medical interventions.

Even though Missouri’s law grandfathered in patients currently being treated, University of Missouri Health announced in August that it would no longer provide puberty blockers and hormones to minors for the purpose of “gender transition.”

That set the stage for a lawyer filing a federal lawsuit on behalf of two minor female patients in the midst of “gender treatment” to appear more like boys. Filed on Nov. 16, the suit seeks to force MU Health to resume prescribing puberty blockers and testosterone for the “gender transition.” One girl has been taking testosterone for 18 months; the other has been taking puberty blockers since she was nine years old.

Their prescriptions are running out, and neither MU Health nor any other provider in Missouri will refill them.

The suit argues that gender dysphoria is a disability causing “physical impairment.” But to be clear, the gender dysphoria diagnosis was created to describe a psychological condition, not a physical one. Those formally diagnosed with gender dysphoria are supposed to have been given this designation based on psychological distress, not a physiological condition.

In reality, the “physical impairments” associated with a simple determination of gender dysphoria are the result of the off-label use of drugs that are dispensed in service to the diagnosis, not because the body is missing a necessary chemical or because of an abnormal growth that must be removed.

Puberty-blocking medication and cross-sex hormones have never been approved by the Food and Drug Administration for use in the treatment of gender dysphoria.

Its use is an experiment on children, based on speculation that it provides some benefit. In fact, recent studies have shown no benefit in minor patients who took them for this purpose. Instead, the drugs have shown to have serious and injurious side effects.

The lawyer and his clients in the Missouri case seem to be unfamiliar with those effects. The risks and harms of using puberty-blocking medication include the following:

  • Liver damage, bone thinning, and skeletal damage.
  • Mental health problems.
  • Brain swelling and vision loss in children (FDA 2022).
  • Infertility, osteoporosis, and cardiovascular disease.

The risks and harms associated with cross-sex hormone use include:

  • For females taking testosterone: heart attacks and strokes, liver dysfunction, type 2 diabetes, male pattern baldness, deepened voice, and facial and body hair.
  • For males taking estrogen: blood clots, heart attacks and strokes, breast cancer, weight gain, and insulin resistance.

The effect of using puberty blockers followed by long-term use of cross-sex hormones is near-certain sterility.

Given these harms, the only real case to make for a disability claim is for detransitioners. Those are the girls and boys, men and women, who were subjected to “gender-affirming care” and must now live with the resulting damage to their bodies.

Heyer’s Own Gender Dysphoria Diagnosis

Like so many people who go down this path, I thought I was born in the wrong body. My therapist, Dr. Paul Walker, agreed. Walker wasn’t a nobody. He was a world-renowned gender therapist and the chairperson of the committee that wrote the original Harry Benjamin International Standards of Care for the diagnosis and treatment of gender dysphoria in 1979.

In 1981, Walker diagnosed me with gender dysphoria. His solution for me was hormones and surgery.

The catch-all diagnosis of gender dysphoria has proven to be one of the most ineffective, harmful, and reckless diagnoses for decades because the only “treatment” allowed in the United States is cross-sex hormones and surgery.

Walker’s wrong diagnosis and misapplied remedy destroyed my family and career, leaving me to cope with a cascading series of horrific events that took me years to recover from.

Walker ignored my adverse childhood experiences, drinking, and drug abuse. But he knew. And practitioners since then should have known as well. The indications have been there all along.

Strike 1, 1979: ‘Too Many Suicides’

In 1979, the first warning shot “fired across the bow” against treating gender dysphoria with hormones and surgery came from Dr. Charles Ihlenfeld, an endocrinologist at Benjamin’s clinic in New York. Ihlenfeld, who administered cross-sex hormones to 500 men over six years, announced he was leaving the clinic to retrain in psychiatry so he could help these people.

Ihlenfeld advised extreme caution in giving hormones and surgery because, in his opinion, 80% of the patients who want to change their sex shouldn’t do it. “There is too much unhappiness among people who have had the surgery,” he said. “Too many of them end as suicides.”

As for children, Ihlenfeld added he was against giving hormones to persons under 18 years of age, preferring that they be at least 20 or 21. “But in general, identity is still fluid in adolescence. There’s a chance that gender feelings still might change,” he said.

A follow-up study of boys in 2021 confirms Ihlenfeld’s comments. Almost 87% of the boys diagnosed as a child with gender dysphoria desisted by adulthood.

Strike 2, 2004: ‘Sex Changes Not Effective’

In 2004, 25 years after Ihlenfeld’s comments, the University of Birmingham’s aggressive research intelligence facility reviewed “more than 100 international medical studies of post-operative transsexuals” and “found no robust evidence that gender-reassignment is clinically effective.”

Chris Hyde, the facility’s director, noted, “[T]here’s still a large number of people who have the surgery but remain traumatize—often to the point of committing suicide.”

Strike 3, 2023: ‘Gender-Affirming Care’ Is Dangerous

In a 2023 article, Dr. Riittakerttu Kaltiala, the chief psychiatrist in the department of adolescent psychiatry at Finland’s Tampere University Hospital, spoke out.

In “Gender-Affirming Care Is Dangerous. I Know Because I Helped Pioneer It,” she tells her story of opening the first gender-identity service in Finland in 2011. She was surprised to see deteriorated health among minor patients and the advent of social contagion-linked gender dysphoria.

When she published findings from the clinic, she encountered not reasonable concern from advocates, but hostile pushback.

She says her vindication came in 2020 when Finland’s national medical body, COHERE, released its findings and recommendations regarding youth gender transition: “In light of available evidence, gender reassignment of minors is an experimental practice.”

The authors concluded that gender transition should be postponed “until adulthood.” Now, Kaltiala advocates using the Finnish findings worldwide.

Kaltiala asks the powerful question, “My country, and others, found there is no solid evidence supporting the medical transitioning of young people. Why aren’t American clinicians paying attention?”

Now, Missouri lawyers representing cross-gender-identifying children want to turn the often-faux diagnosis of gender dysphoria into a disability.

How many warnings will it take, over how many years, from doctors who work directly with this gender-distressed population, to stop this madness?

This lawsuit must not prevail.

It’s time to follow the science, honor God’s design of men and women, and continue taking measures to protect children.

Dr. Jennifer Bauwens is the Director of the Center for Family Studies at Family Research Council.

Walt Heyer serves as Senior Fellow in the Center for Family Studies at Family Research Council.