'Risks are significant': 21 international doctors warn against 'gender-affirming' hormones, surgeries for youth

A coalition of international doctors wrote an open letter warning against hormones and surgeries as the first line of treatment for youths diagnosed with gender dysphoria.

The letter, published last week by the Wall Street Journal, was signed by 21 clinicians and researchers from nine countries: Finland, the United Kingdom, Sweden, Norway, Belgium, France, Switzerland, South Africa, and the United States.

The doctors' letter was in response to a letter published in early July by the Endocrine Society's president, Stephen Hammes, who advocated for the use of hormone therapy treatments and "lifesaving gender-affirming care."

The Endocrine Society claimed, "More than 2,000 studies published since 1975 form a clear picture: Gender-affirming care improves the well-being of transgender and gender-diverse people and reduces the risk of suicide."

However, the coalition of international doctors pushed back, stating, "This claim is not supported by the best available evidence."

"As experienced professionals involved in direct care for the rapidly growing numbers of gender-diverse youth, the evaluation of medical evidence or both, we were surprised by the Endocrine Society's claims about the state of evidence for gender-affirming care for youth," the doctors wrote.

The letter stated that the "evidence for mental-health benefits of hormonal interventions for minors to be of low or very low certainty," but its "risks are significant." The doctors explained that the risks involved with hormone treatment on children include "sterility, lifelong dependence on medication and the anguish of regret."

"For this reason, more and more European countries and international professional organizations now recommend psychotherapy rather than hormones and surgeries as the first line of treatment for gender-dysphoric youth," the doctors added.

The letter added that treating gender dysphoria has become too politicized in the United States, causing some medical professionals to outright ignore the evidence.

"The politicization of transgender healthcare in the U.S. is unfortunate. The way to combat it is for medical societies to align their recommendations with the best available evidence—rather than exaggerating the benefits and minimizing the risks," the doctors continued.

"Endocrinologists aren't psychiatrists. We aren't the ones who can identify gender-dysphoric individuals. The point isn't to open the floodgates and offer an often-irreversible treatment to all people who may have issues with their sexuality, but to determine who would truly benefit from it," the letter concluded.

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