In his recent State of the Union speech Joe Biden said: “Affirming a transgender child’s identity is one of the best things a parent, teacher, or doctor can do to help keep children from harm, and parents who love and affirm their children should be applauded and supported, not threatened, investigated, or stigmatized.”

If the US President chooses to use his bully pulpit to endorse it, transgender “affirmation” is obviously the conventional wisdom in the world’s most influential nation. But what evidence is there for accepting the claims of transgender medical treatment? MercatorNet asked Bernard Lane, a veteran Australian journalist who recently launched a Substack blog on the topic, Gender Clinic News.

Can you give us an idea of how widespread the phenomenon of gender dysphoric teenagers is?

The lack of good data is one of the red flags that tells you “gender medicine” is not like any other kind of medicine.

We have basic patient data for a clutch of big gender clinics in some affluent capital cities around the world. The rate of growth since the take-off period, roughly 2010-15, is exponential.

Most people who are worried about this trend believe that the United States has the biggest number of minors undertaking medicalised gender change — and the most lax procedures when it comes to mental health assessment, child safeguarding, and patient follow-up.

There’s very little good data from the US, with its decentralised health system. Canada seems a black hole for data, as well. Countries with national health systems, such as Sweden and the UK, have better data.

After the US, the UK would probably be the next biggest in patient numbers. Per capita, however, Australia has significant caseloads in the public children’s hospitals of Melbourne, Brisbane and Perth.

My impression, just an impression, is that medicalised gender change is newer, and on a smaller scale, in countries such as France, Germany and Spain. I’m told the trend is also present in the richer regions of Latin America.

Has social media played a role in the rapid spread of transgender treatment?

Some activists still insist that the kids are such experts on their “gender identity” that they are immune from peer influence.

However, nobody serious discounts the possibility. Recently, top “gender affirming” clinicians in America have conceded that social contagion online and via friendship groups is happening at some level.

It’s long been known that adolescent girls are especially vulnerable to social contagion, and there seems no good reason why gender dysphoria would be an exception.

The take-off period of 2010-15 roughly coincided with the emergence of the first generation of teens raised on social media. This is Dr Jonathan Haidt’s “Coddling of the American Mind” demographic with its emotional and intellectual fragility.

Surely medical organisations and children’s hospitals wouldn’t endorse these treatments without rock-solid evidence.

That was my assumption in 2019 when I first talked to health professionals who were troubled about youth gender clinics. The last few years have shaken my confidence in institutions — not just medical organisations but education systems and media outlets.

What’s happening is more understandable if you see gender clinics as practicing a hybrid medical-and-identity-politics model. The imperative of “trans health rights” appears to have had the effect of lowering standards of evidence, safeguarding, and informed consent for gender medicine.

These young people are obviously hurting. Why should their doctors and their parents deny them the means to make them happy?

Maybe the gender clinics could start a program for new referrals, matching them up with young adult “detransitioners” who have stopped taking hormones and reclaimed their birth sex. Those detransitioners might tell the would-be transitioners that high hopes for medical treatment, especially for gender medicine with its weak evidence base, can be disappointed in practice, leaving a patient with side effects and regret.

How well has the global media handled this phenomenon?

Not well. The Brits have been best at applying normal journalistic scrutiny to youth gender clinics. Many once august media outlets in the US churn out repetitive propaganda, in which gender medicine is always “lifesaving” and any sceptics are uniformly hateful bigots. No country has been spared this pseudo-progressive coverage, which reflects the political culture of journalists as a class and the unexamined assumption that a trans kid on hormones is today’s version of the glory days of 1970s and 1980s gay liberation.

Is there a medical consensus on why this is happening? What’s your theory?

One of the signs of progress is that, little by little, health professionals are realising there is no medical consensus on invasive medical treatments for young people who often believe they’ve been “born in the wrong body”.

I think we are witnessing now the end of the period in which, in part thanks to lazy or activist journalism, there was a false sense of medical consensus that the “gender affirming” model and hormonal and surgical treatments were the only game in town.

Why are you so passionate about this issue? The number of children involved is very small.

I suppose what drew me into this story was the drastic nature of these medical interventions with young people and the unusual mind/ body philosophy which supposedly justified it. Then there’s the despair and disbelief of parents as they watch their children medicalised. 

Also, I couldn’t ignore the fear, dishonesty and intimidation that surrounds this particular topic.  I’ve never seen anything like it in more than three decades of journalism. And a big part of this extraordinary and troubling story — which, in my opinion, has the hallmarks of an international medical scandal — is the failure of journalism to do its job.

Gender Clinic News is an independent newsletter with global coverage of the debate about medicalised gender change among young people. Subscribe here.

Bernard Lane is an Australian journalist on the gender clinics beat. He covers local and global news about the trend for children and adolescents to undergo medicalised gender change.