First Do No Harm

First Do No Harm

This article highlights developments in Sweden and England regarding recommended treatments for gender dysphoric minors and has direct application to current Maine events. In recent years both country’s national health boards have supported hormonal and psychological interventions relying on a model originating in the US. Neither country ever allowed gender surgery on minor children and that will stay. Regarding the other medical interventions, however, things have changed!

In February of 2022, Sweden revised its recommendation for treatment. The Swedish National Board radically changed its view on hormone treatments for minors, concluding that the risks outweigh the benefits. Key conclusions, as reported by Society for Evidenced Gender Medicine (SEGM), were:

  1. Hormonal interventions were of low quality, lacking a scientific basis to the extent that no one knew if the treatments were effective or safe.
  2. Hormonal interventions may carry risks. The Karolinska Hospital saw side effects of cardiovascular disease, infertility, cancer and thrombotic disorder. (Karolinska University Hospital has been ranked one of the top ten hospitals in the world by Newsweek Magazine).
  3. Poorly understood marked change in demographics: the sharp rise in the number of youth seeking to transition and the change in sex ratio toward a preponderance of females is not well-understood.
  4. Increasing reports of detransition and transition-related regret among youth who transitioned in recent years.

More recently, in October of 2022, England’s National Health Service (NHS) issued new draft guidance for treatment, which sharply deviates from the previous “gender affirming” approach. As reported by SEGM, the NHS has, in addition to seven more technical, administrative recommendations

  1. Eliminated the “gender clinic” model of care and done away with “affirmation”.
  2. Established psychotherapy and psychoeducation as the first and primary line of treatment.
  3. Sharply curbed medical interventions and confines puberty blockers to research-only settings.

The NHS went further, determining that “social gender transition” including adults adopting a minor’s preferred name, pronoun and gender role is actually a form of psychosocial intervention with potentially serious risks. Dr. Hilary Cass was commissioned by NHS to evaluate the country’s main gender clinic, which was subsequently closed. She concludes that social transitions should not be regarded as a “neutral act” of support but as a psychosocial intervention that can alter the course of a child’s development.

As reported in the Arkansas Save Adolescents from Experimentation (SAVE) Act, only a small percentage of the American population experiences distress at identifying with their biological sex. The American Psychiatric Association has noted the prevalence varies by sex with many more males that females. Most of these, when treated traditionally will reconcile with their biological sex, eventually declaring to be gay or lesbian. Applying AAP percentages to the Maine school population, one might expect there to be 24 males and 2 females statewide who have distress at identifying with their biological sex. Why the explosion in numbers, especially among girls?

Having doubts about Maine’s approach to the treatment of minors and involvement of the school system? Don’t dread to ask these questions:

  1. Why is the state adopting a curriculum, regarded by experts as a “psychosocial intervention that can alter the course of a child’s development”?
  2. Are puberty blockers being given to Maine children without parental consent? There are credible reports that this is the case.
  3. What are the risks of puberty blockers?
    1. Hormonal suppression of puberty may permanently alter neurodevelopment, affecting the capacity to give informed consent
    2. Pubertal suppression may alter the course of gender identity development, locking in a gender that may have been reconciled
    3. Concerns of irreversible effects on sexual function and bone development
    4. Concerns of sterility, admitted by Boston Children’s Hospital gender doctor and reported by Karolinska Hospital
  4. Why are there no peer reviewed studies of Maine’s approach? Why are you experimenting on Maine children and hiding your treatment from parents?