There are no studies that compare the health outcomes of children and adolescents who receive gender-affirming care with those whose gender dysphoria resolved after puberty without medical or surgical intervention.

“We wouldn’t consider a drug that stunted your growth in height and weight to be a psychologically neutral intervention – because it isn’t…”

Abigail Shrier

“Gender-affirming care” is a misnomer.
It’s not caring at all.


  1. See Michelle A Cretella, “Gender Dysphoria in Children and Suppression of Debate” 21, no. 2 (2016). ↩︎
  2. See Society for Evidence-Based Gender Medicine, “International Perspectives on Evidence-Based Treatment for Gender-Dysphoric Youth Conference,” October 10-11, 2023, New York ↩︎
  3. See Yarhouse, Understanding Gender Dysphoria, 102–3. for a description of these approaches ↩︎
  4. Shrier, Irreversible Damage, 165. ↩︎
  5. Shrier, 164. ↩︎
  6. Lupron, (October 12, 2021), RxList, https://www.rxlist.com/lupron-drug.htm ↩︎
  7. Talal Alzahrani et al., “Cardiovascular Disease Risk Factors and Myocardial Infarction in the Transgender Population,” Circulation: Cardiovascular Quality and Outcomes 12, no. 4 (April 2019): e005597, https://doi.org/10.1161/CIRCOUTCOMES.119.005597; Michael S. Irwig, “Cardiovascular Health in Transgender People,” Reviews in Endocrine and Metabolic Disorders 19, no. 3 (September 1, 2018): 243–51, https://doi.org/10.1007/s11154-018-9454-3; Stephen M. Rosenthal, “Challenges in the Care of Transgender and Gender-Diverse Youth: An Endocrinologist’s View,” Nature Reviews Endocrinology 17, no. 10 (October 2021): 581–91, https://doi.org/10.1038/s41574-021-00535-9; Silvano Bertelloni et al., “Final Height, Gonadal Function and Bone Mineral Density of Adolescent Males with Central Precocious Puberty after Therapy with Gonadotropin-Releasing Hormone Analogues,” European Journal of Pediatrics 159, no. 5 (April 1, 2000): 369–74, https://doi.org/10.1007/s004310051289; Ana Antun et al., “Longitudinal Changes in Hematologic Parameters Among Transgender People Receiving Hormone Therapy,” Journal of the Endocrine Society 4, no. 11 (November 1, 2020): bvaa119, https://doi.org/10.1210/jendso/bvaa119; Hayley Braun et al., “Moderate-to-Severe Acne and Mental Health Symptoms in Transmasculine Persons Who Have Received Testosterone,” JAMA Dermatology 157, no. 3 (March 1, 2021): 344–46, https://doi.org/10.1001/jamadermatol.2020.5353; Mauro E. Kerckhof et al., “Prevalence of Sexual Dysfunctions in Transgender Persons: Results from the ENIGI Follow-Up Study,” The Journal of Sexual Medicine 16, no. 12 (December 1, 2019): 2018–29, https://doi.org/10.1016/j.jsxm.2019.09.003; Spyridoula Maraka et al., “Sex Steroids and Cardiovascular Outcomes in Transgender Individuals: A Systematic Review and Meta-Analysis,” The Journal of Clinical Endocrinology & Metabolism 102, no. 11 (November 1, 2017): 3914–23, https://doi.org/10.1210/jc.2017-01643; M. Kyinn et al., “Weight Gain and Obesity Rates in Transgender and Gender-Diverse Adults before and during Hormone Therapy,” International Journal of Obesity 45, no. 12 (December 2021): 2562–69, https://doi.org/10.1038/s41366-021-00935-x; Sebastian E E Schagen et al., “Bone Development in Transgender Adolescents Treated With GnRH Analogues and Subsequent Gender-Affirming Hormones,” The Journal of Clinical Endocrinology & Metabolism 105, no. 12 (December 1, 2020): e4252–63, https://doi.org/10.1210/clinem/dgaa604; Daniel Klink et al., “Bone Mass in Young Adulthood Following Gonadotropin-Releasing Hormone Analog Treatment and Cross-Sex Hormone Treatment in Adolescents With Gender Dysphoria,” The Journal of Clinical Endocrinology & Metabolism 100, no. 2 (February 1, 2015): E270–75, https://doi.org/10.1210/jc.2014-2439; Magdalena Dobrolińska et al., “Bone Mineral Density in Transgender Individuals After Gonadectomy and Long-Term Gender-Affirming Hormonal Treatment,” The Journal of Sexual Medicine 16, no. 9 (September 1, 2019): 1469–77, https://doi.org/10.1016/j.jsxm.2019.06.006; Darios Getahun et al., “Cross-Sex Hormones and Acute Cardiovascular Events in Transgender Persons,” Annals of Internal Medicine 169, no. 4 (August 21, 2018): 205–13, https://doi.org/10.7326/M17-2785; Mariska C. Vlot et al., “Effect of Pubertal Suppression and Cross-Sex Hormone Therapy on Bone Turnover Markers and Bone Mineral Apparent Density (BMAD) in Transgender Adolescents,” Bone 95 (February 1, 2017): 11–19, https://doi.org/10.1016/j.bone.2016.11.008; Iris E. Stoffers, Martine C. de Vries, and Sabine E. Hannema, “Physical Changes, Laboratory Parameters, and Bone Mineral Density During Testosterone Treatment in Adolescents with Gender Dysphoria,” The Journal of Sexual Medicine 16, no. 9 (September 1, 2019): 1459–68, https://doi.org/10.1016/j.jsxm.2019.06.014; Michael Biggs, “Revisiting the Effect of GnRH Analogue Treatment on Bone Mineral Density in Young Adolescents with Gender Dysphoria,” Journal of Pediatric Endocrinology and Metabolism 34, no. 7 (July 1, 2021): 937–39, https://doi.org/10.1515/jpem-2021-0180; Rafael Delgado-Ruiz, Patricia Swanson, and Georgios Romanos, “Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy,” Journal of Clinical Medicine 8, no. 6 (June 2019): 784, https://doi.org/10.3390/jcm8060784; Tobin Joseph, Joanna Ting, and Gary Butler, “The Effect of GnRH Analogue Treatment on Bone Mineral Density in Young Adolescents with Gender Dysphoria: Findings from a Large National Cohort,” Journal of Pediatric Endocrinology and Metabolism 32, no. 10 (October 1, 2019): 1077–81, https://doi.org/10.1515/jpem-2019-0046; Kyinn et al., “Weight Gain and Obesity Rates in Transgender and Gender-Diverse Adults before and during Hormone Therapy”; Noreen Islam et al., “Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data From the STRONG Cohort,” The Journal of Clinical Endocrinology & Metabolism 107, no. 4 (April 1, 2022): e1549–57, https://doi.org/10.1210/clinem/dgab832. ↩︎
  8. See Coleman et al., “Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.” for a sample of studies ↩︎
  9. Cecilia Dhejne et al., “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden,” PLOS ONE 6, no. 2 (February 22, 2011): e16885, https://doi.org/10.1371/journal.pone.0016885. ↩︎

Among children who exhibit gender dysphoria prior to puberty, approximately 80% will “desist” or out-grow this dysphoria by adulthood.

“The fundamental problem with gender-affirming care is that it misdiagnoses the problem.”

“The solution is not to radically reshape the body through drugs, hormones, and surgery. The solution is to help someone accept and love their natural body. ”

The message from the Alberta premier is clear: children do not have the capacity to make these profound decisions about their bodies.

These developments – particularly the age restrictions for medical transitioning – are enormous.

“Accepting and appreciating that there is a natural connection between sex differences and gender differences is essential for preserving mental and emotional well-being.”

“Biological sex, gender, and gender identity are all connected, not separate.”

So, what are human beings, anyways?