Gender transition is a harmful but popular fad promoted by adults in K-12 schools, universities, hospitals, medical associations, media organizations such as National Public Radio, teachers’ unions, and foundations such as the Tides, Arcus, Novo, Tawani, and Open Society Foundations. Most of these organizations benefit directly or indirectly from taxpayer funding.
Girls are getting dangerous, brain-affecting anabolic-androgenic steroid (testosterone) or GnRHa (estrogen-blocking) drug treatments for gender transition purposes without FDA approval or adequate testing (see also “Lupron”; Millican). Some get mastectomy surgeries when they are just 13 or 14 years old.
Young women are getting hysterectomies. Young men are getting surgical procedures that entail the “skinning and removal of the penis.” Boys are getting genital surgeries. Many female and male patients deeply regret their drug and surgical treatments.
Planned Parenthood is “the second largest provider of transgender hormone therapy services” nationally.
Planned Parenthood gets approximately half a billion dollars from taxpayers annually and spends millions on political activities, targeting figures such as Sen. Susan Collins. Some Planned Parenthood clinics provide transition treatments for both males and females. Planned Parenthood has allegedly sponsored events at which “heterosexual male transgenders” can “advocate for the corrective rape of lesbians who ‘oppress’ them by denying them sexual contact.”
Female-to-male gender transition treatments have been growing exponentially for about a decade now. In Britain, referrals of girls for gender transition treatments rose by more than 4,000% in less than ten years. Canada, the U.S., and many other Western countries have also seen spikes in female-to-male treatments.
Social media, animé culture, “white guilt,” anti-lesbian/gay bullying, underlying psychiatric disorders and autism, and peer pressure to transition have catalyzed the gender transition fad among both males and females (see also “Baptised”; “Geeks”; “It’s not conversion”; Marchiano; Williams).
The Obama administration’s pro-transition mandates for healthcare providers and schools, funding of transition advocates (see also “7-year-old”), and other actions also helped to propel the transition fad.
Few patients seeking gender transition treatments have physical disorders of sex development or “intersex” disorders. Even gender transition advocates acknowledge that the “majority of transgender individuals do not have a disorder of sex development” (see also Auer; Dessens; Inoubli; Meyer-Bahlburg; Pang; Razzaghy-Azar).
In contrast, many young people with gender identity difficulties have autism, cognitive disabilities or psychiatric disorders (see Becerra-Culqui; Chen; Devor; Jones; Kaltiala-Heino; Leena; Marchiano; Oswalt; Strang; “Survey”; Vrangalova; Walling). Doctors do provide transition treatments to patients with such conditions (see “14 year old”; “Aydin”; Heyer; “In praise”; Marchiano; Shumer; “Social work”; “USPATH”). Doctors do not require patients to have physical disorders of sex development or “intersex” disorders in order to get transition treatments.
Many gender clinics advertise transition treatments for children. Planned Parenthood clinics claim to limit transition treatments to adults. However, gender transition drugs can also be used for other purposes. Thus, transition treatments may be disguised as treatments for other purposes in minors.
Most medical researchers and practitioners are afraid (or unable) to expose problems with transition treatments. As a result, patients and parents do not understand the risks.
Gender transition profiteers and advocates wield influence over a wide range of organizations, including hospitals, universities, medical journals, professional associations such as the American Academy of Pediatrics and American Psychological Association, K-12 schools, and National Public Radio. Profiteers may include wealthy investors, drug and device companies, and doctors who provide transition treatments or serve as “expert” witnesses or paid promotional speakers or consultants for drug companies.
The FDA and other federal and state regulators have failed to rein in dangerous drug and surgical transition treatments. It is time for lawmakers to act. We need commonsense controls on gender transition treatments. (Click here to see what lawmakers should do.)
Brain Effects of Anabolic-Androgenic Steroids
Gender clinics are prescribing anabolic-androgenic steroid (testosterone), GnRHa (“puberty blocking”), and other drug treatments for gender transition purposes without FDA approval or adequate testing (see also “Lupron”; Millican).
They are prescribing drugs such as Androgel®, Androderm®, Aveed®, Axiron®, Depo-Testosterone®, Delatestryl®, Testim®, and Testopel® (see Forcier; Idaho; Imborek; Meltzer; Metzger; Tom Waddell Health Center; Unger; Warner). Those are anabolic-androgenic steroid/testosterone drugs (Kersey p. 572).
They are used for gender transition in biological females. Biological females constitute the majority of patients at many gender clinics (see Angus; Chen; de Graaf; Kaltiala-Heino). Many of these patients have no childhood history of gender dysphoria (see Kaltiala-Heino; Littman). They may have undiagnosed autism or psychiatric disorders (see also Anderson; MacDonald; Russo; Sigler).
Anabolic-androgenic steroid/testosterone treatments for gender transition purposes raise testosterone dramatically and suppress estrogen and its receptors. An FDA panel rejected a testosterone drug for females years ago because of safety concerns. Testosterone drugs are not FDA-approved for gender transition purposes or for females in general.
Anabolic-androgenic steroid (AAS) drugs “are universally recognized to have psychoactive effects.” The FDA and other agencies have strongly discouraged non-FDA-approved uses of AAS/testosterone drugs because of the risk of adverse brain and behavioral effects and other effects (FDA 2013, 2016, 2017; Fox; National Institute on Drug Abuse 2016, 2017, 2018a, 2018b; 2018c). However, those agencies have not taken steps to reduce the off-label use of AAS or other drugs for gender transition purposes. This omission is endangering young patients.
Transition treatments have already been shown to alter patients’ brain activity, brain structures, and behavioral proneness. They may alter self-related thinking and cause self-harm and suicidality, impaired social cognition, impaired language ability, impaired memory, risk of psychiatric and neurological disorders, altered sexual behaviors, and aggressive, anti-social, and/or criminal behaviors. (Click here to see excerpts from FDA and medical journal articles documenting the risks from AAS/testosterone drugs.)
These treatments can induce mitochondrial dysfunction and may cause oxytocin problems (see Acevedo-Rodriguez; Crespi; Okabe; Rissman). They affect neurotransmitters. Sex hormones can affect the entire brain “through many cellular and molecular processes that alter structure and function of neural systems and influence behavior.”
Clinics are also prescribing GnRHa drugs to block estrogen. These treatments may also affect the brain (see also “Lupron”; Nuruddin). They may cause permanent sterilization and have other adverse effects. (Click here to see excerpts from FDA and medical journal articles documenting the risks from GnRHa drugs.)
Many dysphoric females already have high testosterone or chronic excess testosterone conditions such as polycystic ovary syndrome (POCS) prior to AAS/testosterone treatment (see Auer; Baba; Becerra-Fernández; Bosinski; Futterweit; Mueller).
Female autism, cognitive difficulties, and psychiatric disorders have been linked to PCOS, high testosterone, and/or low estrogen (see Cesta; Cooney; Dettenborn; “Estrogen”; Matevosyan; Meinhard; Newton-Mann; “PCOS”; Pohl; Roberts; Sandoiu; Schwarz; Soleman; Tan; Wooderson; Worsely). Transition treatments might trigger or worsen those conditions by raising testosterone even higher and suppressing estrogen.
The brain effects of AAS/testosterone or GnRHa treatments may contribute to mental illness stigma, social rejection, and HIV/AIDS in female-to-male transsexuals (see also Ip; Lemons), plus other problems (see Carter; Langenderfer-Magruder; Martinez; Spicer).
“Disease Mongering” and Lack of Regulation
Critics say that testosterone drug promoters have engaged in inappropriate “disease mongering” and marketing with regard to “female sexual dysfunction,” “low testosterone” in men, and now gender transition in girls with mental health difficulties.
The FDA has pushed back against unsafe AAS/testosterone drug uses for females, males (also here), and young people in general. However, the FDA has not addressed problems with off-label use of testosterone or other drugs for gender transition purposes specifically. In fact, no federal or state agencies appear to be doing anything about problems related to gender treatments.
Those problems may include gross medical negligence (see Marchiano; Littman), medical fraud (concealing and distorting information to induce patients to agree to treatments, and billing government health programs and insurance for unnecessary treatments), failures to obtain legally sufficient informed consent, failures to investigate and treat hormonal problems such as PCOS in accordance with normal standards of care, failures to diagnose or treat autism or psychiatric disorders in accordance with normal standards of care, unlawful promotion of off-label drug use by drug companies, kickbacks to doctors who refer patients for drug or surgical treatments, and exploitation of (and discrimination against) patients with psychiatric or neurobehavioral disabilities.
Censorship, threats, and retaliation are being used against researchers who expose problems with gender transition in the U.S. (e.g., Chart; “Facebook”; Flier; Harrison; Jontry; “TERF”) and elsewhere (Berenson; Bradley; Heyer; Singal). Some of those actions appear to be coordinated by individuals and organizations that profit from gender transition. Some actions may constitute racketeering (see also Henning).
It is difficult for individual patients to sue doctors for malpractice related to gender transition. Gender transition proponents (and profiteers) now dominate universities, medical associations, medical publishing, mass media, and other fields. Censorship, threats, and retaliation against transition opponents make it hard for patients to find doctors who are willing and able to serve as expert witnesses. In addition, patients with gender dysphoria and other mental health problems often lack the financial, social, and psychological resources needed to mount successful malpractice lawsuits. Therefore, as a practical matter, gender transition patients cannot be protected by the private litigation system alone, even though there is abundant evidence of the dangers of gender transition.
Moreover, monetary damages cannot really make patients whole after they have lost their breasts, voices, hair, reproductive organs, and more due to inappropriate transition treatments. That is why medical regulators must do more to prevent such treatments.
The FDA should strengthen its testosterone drug warnings and require drug labeling changes to clarify the risks of using drugs without FDA approval for gender transition purposes. Federal and state lawmakers should also take other steps to curb inappropriate transition treatments.
Networks of Transition Advocates
Transition treatments are being provided or promoted by universities, hospitals, and other organizations that benefit directly or indirectly from tax dollars. Individuals affiliated with those organizations often have links to the gender transition fad. A recent dispute at Brown University illustrates this.
Lisa Littman, MD, a Brown University researcher, recently published a study exposing serious problems with gender transition in young people. Transition proponents—including university students and faculty and doctors who profit from transition treatments—attacked Dr. Littman’s study. Those attacks were without good cause according to a former dean of Harvard Medical School and other experts. Yet Brown University essentially disavowed Littman’s study. The journal that published the study (PLOS One) said it would conduct a review, although Littman’s study was already reviewed before publication.
Diane Ehrensaft, Ph.D. is director of Mental Health at a University of California pediatric transition clinic and an “expert” witness in gender transition cases. She has suggested that babies and toddlers may signal gender dysphoria by fidgeting or pulling barrettes from their hair. She criticized Dr. Littman’s data sources (reports from parents) even though transition proponents also use such data.
Dr. Littman’s study was also attacked by Michelle Forcier, MD, a leading transition treatment provider and assistant dean at Brown University’s medical school. Dr. Forcier has founded a pediatric gender transition clinic, consulted for Planned Parenthood, and served as a paid promotional speaker for Merck.
A member of Brown University’s board of trustees (Brickson Diamond) is also on the board of directors for the Tides Foundation. That foundation is a leading funder of transition advocacy and has been a donor to Brown University and Planned Parenthood. It gets millions of dollars from taxpayers.
Doctors affiliated with Brown University have co-authored journal articles and continuing medical education presentations touting testosterone drugs for men. Those drugs are also used for female-to-male gender transition.
The New Lobotomy—or New LSD?
People with autism, cognitive disabilities or psychiatric disorders are highly vulnerable to medical mistreatment. They have been lobotomized, sterilized, dosed with LSD, subjected to electrical shock “punishment paradigm” treatments, and deliberately killed by doctors (Brown; Cook; Hornblum; “Screams, slaps”; Sigafoos; Smith; Terrier). Young people with mental health difficulties have been treated as a “gold mine for the drug industry.” Lesbians have also been subjected to medical mistreatment.
Now such patients are being given inadequately-tested, non-FDA-approved drug and surgical treatments—treatments that can disfigure patients, alter their brains, leave them sterile, leave them in chronic physical pain, and possibly leave them dead from suicide. Almost no one in authority seems willing to acknowledge that this might be a bad idea.
Testosterone drugs are profitable. Gender transition is profitable. Profit motives can distort medical research, education, and practice (see Angell; Bosch; Brandt; Brownell; Elliott; Moynihan 2003, 2008a, 2008b; Zettler). Profit motives can be disguised as concern for women’s health and LGBT rights and “patient advocacy.” Supporters of transition promoters and providers—such as Planned Parenthood—should keep this in mind: A doctor or drug company may claim to have a patient’s best interests at heart, but may actually be more concerned about paying off medical school loans, getting a new sports car, driving up a company’s share price or keeping a job at a university.
Universities have much to do with the money and politics of gender transition. Many universities get donations from transition advocates and many universities now sponsor gender clinics, pay for transition treatments, or have faculty and staff who promote transition (e.g., Boston University; Bunim; Campus Pride; Duke University; “Olson-Kennedy”; Olson-Kennedy Laboratory; “Queering”; University of Arizona; University of California-SF; University of Houston; University of Michigan; University of Minnesota; University of Pennsylvania; University of Utah; Washington University). Lawmakers should consider how this is affecting the real-world health care of many K-12 and university students.
The Obama administration did everything possible to make transition more profitable and more widely accepted at the same time that the FDA under Obama was warning about the dangers of AAS/testosterone drugs. The Trump administration has rolled back some Obama initiatives, but neither federal nor state regulators have done enough.
It’s time to act. We need commonsense controls on gender transition treatments.