‘Gender-affirming care’ stems from false compassion

By. Dr. John O'Keeffe

Gender dysphoria is a bodily integrity disorder where a person senses that their biological sex is inconsistent with their gender identity. In other words, “your body is not the real you.”

Reported cases of gender dysphoria have increased 274% from 2018 to 2022 in Virginia. In some schools, up to 20% of pre-adolescent girls are dysphoric about their sex. Is this a psychosocial phenomenon that requires they go down a medical pathway towards gender affirmation? The president of the American Association of Pediatrics (AAP) and its 67,000 pediatricians put out a policy statement in support of transgender youth. However this statement came from the AAP president alone, made no mention of any scientific research findings and mostly reflected a counter argument to conservative views.

What studies have been done on the effects of gender-affirming care? First it must be stated that most studies are touched by bias, politics, and idealism. The TransYouth Project  — an observational study — showed that most of its 300 gender-dysphoric subjects were satisfied with gender-affirming care. A study from the National Institutes of Health showed better mental health outcomes, as did an observational study published in JAMA Network 2023 from Australia (Nolan et al). These studies were looking at the effects of counseling, puberty blockers and sex-hormone treatments. However none of these studies were done using the gold standard of scientific evidence obtained through randomized controlled trials, of which there are few examples in the field of gender-affirming care. There are many experts who have denounced these studies due to their bias and political ideology.

Across the ocean, Finland adopted the Dutch protocol for treating minors, but by 2015 the gender specialists were noticing that most of their patients did not meet the protocols’ strict eligibility requirements, allowing unauthorized treatment of many more minors — especially girls — then was envisaged.

This led to systemic reviews in Europe, culminating in an English study called the Cass Review. It was a large study whose summary statement indicated insufficient evidence for hormone therapy and who would benefit from it, as well as noting that exploratory behavior like gender dysphoria is normal for children. It also stated that gender medicine is built on shaky foundations. As a result of the Cass Review, the United Kingdom, Finland, Norway and Sweden have halted most forms of gender- affirming care until larger studies show benefit.

Here in the United States, a study by Drs. Lawrence Mayer and Paul McHugh at Johns Hopkins University was summarized as follows: The hypothesis that gender identity is an innate fixed property of human beings that is independent of biological sex — that a person might be a “man trapped in a woman’s body” or “ a woman trapped in a man’s body”— is not supported by scientific evidence. Brain studies do not provide any evidence for a neurobiologic basis for cross-gender identification. Researchers found that no one can evaluate the gender identity of a two-year-old. The authors of the study also stated “only a minority of children who experience cross-gender identification will continue to do so into adolescence or adulthood. Surgical treatment increased future hospitalizations, mortality and suicide attempts. Most of the children move back to their biological sex on their own prior to their adolescence (80-90%). Many require behavioral therapy for anxiety as 40-55% have been sexually abused and there seems to be high levels of anxiety in these families (“Gender Identity Disorder and Psychosexual Problems in Children and Adolescents,” Kenneth Zucker and Susan Bradley, 1995).

The Catholic Church teaches us that God created us male and female. Our body is not a prison containing our soul; we are a union of soul and flesh that cannot be separated. Freedom is negated when it is no longer connected to these essential truths of who we are and how God fashioned us.

The arguments for gender-affirming treatment pull on our heartstrings and emotions, but medical treatment must be carefully tailored to provide care and ensure short-term and long-term safety. Modern science is full of missteps which generally occur when investigators cease to question popular opinion or close their eyes to other possible alternatives. We should not make up things up as we go or create more victims — especially children. Rather, medical treatments should be guided by the age-old principal  Primum non nocere: first, do no harm.

(Dr. John O’Keeffe is a family practice physician and a member of St. Francis of Assisi Parish in Colorado Springs.)