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Commentary

Germany Joins Nations Skeptical of Gender Transition Procedures for Minors as Evidence of Harms Mounts

May 21, 2024

The case for treating children with gender transition procedures is falling apart in real time before our eyes. Earlier this month, yet another European country backpedaled from the perversely named “gender-affirming care” model when delegates at the German Medical Assembly overwhelmingly voted for restrictions, as mounting evidence shows the harms of these procedures and the lack of benefits.

The case for providing gender transition procedures for minors was never a scientific one. There is no stockpile of data showing that children with gender dysphoria live happier lives if affirmed in their delusion. Rather, advocates endorse these procedures for ideological and political reasons. They argue from expressive individualism that any biological manipulation is justified which conforms a person’s physical body to their felt identity. They distract from the scantiness of the data with bald-faced appeals to the authority of the medical organizations they have captured. They demand others “trust the science” (meaning experts) when they themselves do not “follow the science” (meaning data).

Thus, in a 120-47 vote, the 128th German Medical Assembly called on the government to restrict the use of puberty blockers, cross-sex hormones, and gender transition surgeries for minors to “the context of controlled scientific studies,” and only with the involvement of “a multidisciplinary team and a clinical ethics committee,” to consider “psychiatric diagnosis and treatment of any mental disorders.” They also called for long-term evaluation on the social, psychological, and psychiatric health of children.

The German Medical Assembly gathers 250 delegates from 17 German medical associations. Thus, it represents not one medical organization, but all of them, when it approved this resolution in a nearly 3-1 vote.

The German Medical Assembly passed another resolution by a smaller, but still substantial, margin (110-64), which disapproved of “self-ID” legislation and stated that minors should not be allowed to “self-identity” their gender without a prior psychiatric diagnosis.

What? Not allow minors to choose their own gender without a psychiatric diagnosis? Postpone irreversible, life-altering gender transition procedures until children are old enough to consent? America’s most enlightened medical organizations would never be so “uncool.”

Indeed, that inappropriate value has propelled the entire movement to treat minors with gender transition procedures with relentless negative peer pressure to not be seen as uncaring or non-inclusive. No medical malpractice lawsuit, no ethical quandary, no deceptive or manipulative advertising would pain the “cool” doctors more than, say, a negative review from the Human Rights Campaign (HRC).

But servitude to a momentary fad can cut both ways; what may have been cool yesterday is out of fashion today. And the unrestrained rush toward gender transition procedures — in which American health care professionals are currently disgracing themselves — is already falling out of fashion. Last week, a top British doctor, Dr. Hilary Cass, criticized American medical associations for “holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.” Nothing is more embarrassing for fad-followers than to be “out of date.”

Indeed, if the American organizations would put an ear to the pond, they could plainly hear the trans-Atlantic warning sirens sounding the alarm on the dangers of transitioning children. Countries like the U.K. once performed gender transition procedures on minors at government-run health care centers. But, after a four-year review led by Dr. Cass, the nationalized health care system turned sharply away from procedures for which there was such “remarkably weak evidence.”

If the evidence for gender transition procedures is so weak, why have so many medical organizations endorsed them? Their desire to be part of the “cool” crowd was so strong that medical organizations abandoned their own best judgment and simply endorsed the practice because other groups had done so. In her report, Cass said the “apparent consensus” was really based on “circularity,” whereby medical organizations’ recommendations relied on one another, “despite the evidence being poor.”

Since then, the evidence has only gotten worse for those advocating gender transition procedures for children.

Emails included in a recent court filing reveal that the World Professional Organization for Transgender Health (WPATH), to which most medical associations’ recommendations link back, suppressed the publication of academic research because it did not reach their desired conclusion. In 2020, WPATH prevented Johns Hopkins University researchers from publishing research WPATH had commissioned, after learning their review of the evidence “found little to no evidence about [the use of gender transition procedures for] children and adolescents.”

WPATH went on in 2022 to publish the eighth edition of its “Standards of Care” for gender transition procedures, which removed almost all age restrictions on the procedures.

The problems don’t end with the lack or suppression of evidence. A study published last month found that people who underwent gender transition surgery were 12 times more likely to attempt suicide than those who did not.

A fad supporting something so outrageous can’t survive for long. Soon, it will be seen for what it has been all along: decidedly not cool. This outcome provides an excellent reason to press pause on these procedures, on which there is very little data and which seek to undermine a person’s fundamental biology.

Joshua Arnold is a senior writer at The Washington Stand.