Most Americans are painfully unaware that pediatric “gender medicine” is reaching a fever pitch.
For the rest of the world, the tide has already turned. Studies out of the UK and Finland have urged caution, pointing to a weak evidence base, a lack of long-term data, and the back-seating of frontline psychological care. Adolescent detransitioners — people transitioned as children and teens — continue to come forward in droves.
Look no further than the bombshell report released by the U.S. Department of Health and Human Services (HHS): “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine.’”
In 64 pages, HHS alleges that hospitals, “gender clinics,” and insurance companies have committed egregious misuses of power by driving young people struggling to develop a healthy sense of self to pursue elective hormones and surgeries. This bet — gambling physical health for a temporary mental health fix — can bag providers up to seven figures over a patient’s lifetime.
This price tag helps explain why malpractice cases like mine can’t be dismissed as isolated. According to the report, pediatric “gender medicine” grew from a small number of specialized clinics in the early 2010s to at least 225 hospitals and health systems nationwide by the early 2020s. Data cited by HHS identified nearly $120 million in submitted charges since 2019, including more than 5,700 surgical procedures on minors. More than 8,500 minors received opposite-sex hormone treatments or medications to “block” puberty.
Even these figures fail to accurately capture the magnitude of the issue. Since outcomes of transgender interventions were first tracked, there has never been reliable data on regret or detransition. Proponents of gender identity theory claim detransition rates are abysmally low, but short follow-up periods and high loss to follow-up point out where researchers miss: patients who distrust captured academics, face provider abandonment, or don’t survive to follow-up.
It’s a story that hits close to home for me. I rejected my female sex for years in adolescence before physicians gave teenage me the green light for off-label testosterone and an elective double mastectomy. After ideologue providers botched my mastectomy and left me for dead, I became aware, at age 19, of the exploitative machinery underpinning this “care.”
Like many other people I’ve met who flirted with these identities, I came from a broken home and felt lost, struggling with what being female meant for me. When I began to identify as transgender, I was only 11. I had been sexually abused and groomed by strangers on the internet.
I reached out to my biological father a few years later, at 15, and self-admitted to a psychiatric hospital shortly thereafter. When a psychiatrist in that hospital affirmed my transgender identity to my family as the source of my distress, we were shot into a pipeline that made physically maiming me seem like our only alternative to death by suicide.
It’s been four years since I broke from that pipeline and stopped identifying as transgender. I’m still seeking justice and doing my best to exemplify peace in the aftermath. The Supreme Court of Texas ruled that the legal case against my former therapist — a woman who knew the nature of my abuse and still signed off on my mastectomy — could move forward in June.
What I didn’t understand then, and what many still refuse to admit now, is that the affirmation-only model of care moves faster than a child’s ability to comprehend it.
The wave of young people stepping forward who once believed transition would resolve their distress shares complicated, often painful testimonies. Many detailed growing catalogs of physical side effects and long-term health diagnoses, both known and unknown. Their stories imbue us with the awareness that, like mine, these outcomes were preventable.
Doctors, nurses, therapists, psychiatrists, and more all fell into line; some of them even led it. Now, we know this movement was concerted, with incentives to move quickly and abandon caution. Why worry about a child’s quality of life if “experts” claim that their life may be lost — or even taken — if we don’t act immediately?
Medicine is supposed to be grounded in caution and evidence, with an oath to “do no harm.” Yet the arena of “gender medicine” is treated as exceptional, with an evidence base that’s virtually non-existent and inherent harms that are dismissed or minimized. Although considering patients’ desires is standard practice in most medical contexts, granting every desire, especially when it involves self-injury, is not.
That line is now being held at the federal level. The Department of Health and Human Services has examined the records and billing practices of numerous hospitals, health centers, and state health authorities. The Department of Justice has issued more than 20 subpoenas to doctors and clinics that performed pediatric “gender-affirming” interventions.
The results are concrete and promising. In May, Texas Children’s Hospital agreed to a $10 million settlement over allegations that it billed Medicaid to perform banned procedures using false diagnosis codes. The agreement mandated institutional changes and funded the hospital’s first detransition clinic for the next five years. Weeks later, Cleveland Clinic settled similar billing allegations and committed $2 million to restorative detransition care.
As real as they are, these outcomes are primarily legal and financial. A settlement closes a case. It does not, however, establish that care within the new model is competent or that anyone is positioned to notice when it’s not. With agreements that are new and untested, our ability to enforce them will be as strong as our understanding of detransition. Sharpening this understanding requires research, including listening closely to the perspectives of those in recovery.
It is clear to me that people who transition are legitimately struggling. I know because I was one of them — and in a sense, I’ll never not be. “Detransition” is a misnomer that implies I can return to a reality where my body is whole and medical institutions never hurt me. I can’t.
Still, there’s no reason we should be misguiding our most creative young people and vulnerable loved ones to believe that “sex changes” are possible — let alone that they should pursue them when their judgment is severely clouded, as part of embodying their “true, authentic selves,” or before they can make other consequential decisions about their lives.
I often think about what would have happened if the adults responsible for my health and protection had stopped to consider the long-term consequences of their decisions. My developmental stage precluded me from doing it on my own; our medical culture saw to it that no one would help me.
Now Uncle Sam is stepping in.