A major European psychiatric organization has warned doctors against promoting “experimental” transgender “treatments” to gender-confused children and adolescents
The European Society of Child and Adolescent Psychiatry (ESCAP) published a policy statement urging healthcare providers “not to promote experimental and unnecessarily invasive treatments with unproven psycho-social effects and, therefore, to adhere to the ‘primum-nil-nocere’ (first, do no harm) principle.”
The scientists of ESCAP highlighted the “poor reliability and instability of a gender dysphoria diagnosis in a specific child over time” and the “possible effects of the decisions to block puberty or preventing medical transitioning on a child’s psychosocial development.”
The report also stressed that “research findings are published solely on the grounds of quality criteria and not based on their findings.” In a post on X, formerly known as Twitter, the Society for Evidence-Based Gender Medicine (SEGM) interpreted this statement to mean that many recent studies reporting favorably about so-called “gender transition” are “deeply methodologically flawed.”
While the ESCAP report remained open to the possibility that some children might benefit from so-called “gender-affirming care,” it underscored the lack of quality research to accurately determine the risk-benefit ratio of interventions such as hormone blockers and mutilating surgeries.
The policy paper reminded its readers of core ethics principles that need to be observed in the cases of gender-confused minors:
- the principle of non-maleficence: do not use outside the research environment any experimental interventions with potentially irreversible effects, or interventions with unknown long-term consequences; do not adopt new practices prematurely without sufficient evidence; do not continue with outdated practices that might not be in the best interest of the patient.
- the principle of beneficence: adopt medical interventions with favorable benefits-to-harms ratio; consider benefits-to-harms ratio of not providing medical interventions; ensure adequate diagnosis and treatment of co-existing psychiatric disorders; ensure comprehensive diagnostic assessment of gender dysphoria instead of only relying on the self-assessment of children and adolescents.
- the principle of autonomy: involve minors in the decision-making processes around their care in an age- and development-appropriate manner, assessing their capacity to consent; adopt an adequate informed consent process for possibly lifelong and irreversible decisions, securing that children and adolescents fully understand the potential risks, benefits, and irreversible nature of the treatments; consider the rights of their parents and guardians to consent to any major intervention or for participation of their children in research on experimental treatments; consider the rights of their parents and guardians to be fully informed about the current care for their children; offer adequate support and resources to those who decide to de-transition to their assigned sex, and respect their decision to do so.
- the principle of justice: ensure access to reliable and up-to-date information, assessment, and treatment for gender dysphoria, and during transition or de-transition; adopt equal precautionary measures for all; and protect the rights of children and young people as a group in a particularly vulnerable developmental phase.
The ESCAP policy paper represents the latest example of the growing pushback from the medical establishment in Europe to so-called “gender-affirming care.”
In the U.K., the publication of the Cass Review has caused many healthcare providers to change their practices of prescribing harmful puberty blockers or cross-sex hormones to minors. Dr. Hilary Cass, the pediatrician commissioned by the UK’s National Health Service to review the transgender “services” being made available to dysphoric minors, found that “gender medicine” is “built on shaky foundations” and that while these drastic interventions should be approached with extreme caution, “quite the reverse happened in the field of gender care for children.”
Scottish gender clinics and the British National Health Service (NHS) have since halted the prescription of puberty blockers.
Other European countries like Denmark and Sweden have also moved away from the so-called “affirmative model of care” of minors who struggle with gender dysphoria in the recent past.