Restricting the medical interventions available to children of mixed gender is the right thing to do

I will never forget the message I received after the last column I wrote on the complexities of gender dysphoria and transgender youth. It was from a friend over 25 years old. He shared with me that he and his wife have a child who is suffering this way. He thanked me for speaking with compassion on the matter.

You could have knocked me over with a feather. When I wrote the column, I had no idea. My friends had managed to keep their child’s struggle very private. My heart broke for each of them.

It also helped to understand this point: the explosion of young people confused between the sexes is very real, and it is all around us. It doesn’t happen “out there” somewhere.

The prevalence of gender dysphoria among adolescents has skyrocketed in the West in recent years. For decades, the typical child with gender dysphoria was most often born male and exhibited symptoms well before puberty. But a radical change has occurred: in just one year between 2016-2017, the number of gender reassignment surgeries for people born female quadruple. An alarming number of teenage girls suffer from what is known as rapid onset gender dysphoria, which means that they had no symptoms in childhood but began to think of themselves as transgender in their teens, often very suddenly.

Lisa Littman, a researcher at Brown University, noticed that these young women often declared their new gender identities in tandem with friends. Their parents reported that their daughters began to spend more and more time online immersing themselves in stories and content about gender transition before “stepping out” as transgender.

Littman hypothesized that the surge in the number of transgender adolescents is rooted in something other than an organic psychological or physiological predisposition to gender dysphoria. Perhaps, She suggests, it is a coping mechanism for young women who simultaneously suffer from depression or anxiety. Nowadays, they may have developed an eating disorder or resort to behaviors like cutting to cope with the psychological pain they are experiencing.

Today, young people can find a chorus of advocates online to suggest that the reason they feel so out of place in the world is related to their gender identity.

What is really going on here? A study doesn’t have all the answers, of course, but it’s clear that there is a lot we don’t know. In light of this reality, wisdom – and compassion – demands that we curb treatments that have long-term consequences for children and youth in difficulty.

Members of the Alabama legislature are considering two bills limiting the types of treatment available to minors diagnosed with gender dysphoria. The bills, HB1 and SB10, each advanced out of committee and may soon be voted on in their respective chambers.

The House bill, titled The Alabama Vulnerable Child Compassion and Protection Act, prohibits the use of puberty-blocking drugs, hormone therapy, and surgeries for children and adolescents under the age of 18. The bill was amended in committee to allow psychologists to continue counseling underage patients on transgender therapy.

The House Judiciary Committee heard testimony from doctors on both sides of the issue, as well as the compelling story of a father who firmly believes these therapies saved his teenager’s life.

These stories are important and we must listen to them carefully, considering each of them. But we must also remember that we can find anecdotal support for almost any point we want to make. Sound public policy that serves the best interests of many must be built on the basis of broad knowledge, sound science and reason.

For example, we need to discern why the prevalence of gender dysphoria among American adolescents has suddenly exploded. No reasonable person could conclude that human biology / psychology and natural GD increased dramatically overnight. But cultural dialogue and access to highly compelling internet content has done it.

Do we want to allow injured children and frightened parents to make decisions with long-term negative consequences in a time of confusion? Yes, there are doctors involved. But the science here is far from clear, and there is little consensus among medical professionals on the best treatment for gender dysphoria at this time. Additionally, doctors are humans, which means their clinical judgment can also be influenced by cultural narrative.

We must consider the stories of individuals who have gone through a medically assisted gender transition to regret it. A quick Google search reveals a Reddit group for people trying to “de-transition” with over 17,000 members. Thousands and thousands of Americans have – while searching for answers in a season of pain – jumped from that high plunge and now wish they hadn’t. They are now faced with a multitude of medical and physical problems related to the treatments in which they have participated.

It is one thing to allow an adult to exercise their freedom to choose something so risky. It’s another thing to sit there while a child – a human whose frontal lobe won’t fully develop until 23 years old – tries to properly assess risk.

My Christian faith impresses me that we must take care of the most vulnerable. To watch them. To defend them in the public square. There are few more vulnerable than a depressed, anxious and confused child. They deserve mental health and medical care rooted only in the best research and science – not solutions influenced by a cultural narrative of the moment and a desire for quick psychological pain relief at all costs.

For these reasons, restrictions on the types of medical interventions available to minors of both sexes are the right thing to do, and the Alabama legislature should pass these bills.

Dana Hall McCain writes on faith, politics and culture for AL.com. You follow her on Twitter @dhmccain.


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Ray Coulombe

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