Dispatches from Deutschland: A Conference Signals Change
By David Allison
In March 2025, the S2k guidelines in Germany, Austria, and Switzerland endorsed rapid medical affirmation for gender incongruence in minors using puberty blockers, hormones, and surgeries without age limits, dismissing psychotherapy as unethical, despite criticism from the German Society of Psychiatry for lacking evidence and enabling self-diagnosis-driven interventions. Hospitals continue these treatments under social insurance in a decentralized system, evading federal oversight, amid growing opposition from parties like the AfD.
This year’s SEGM (Society for Evidence-Based Gender Medicine) conference took place in Berlin, Germany, bringing together over 150 researchers, clinicians, and academics from 24 countries. The exact location, kept secret from participants until the morning of the event for security reasons, could be seen as a sign of growing confidence among gender realists. Berlin, Germany’s capital, is also a hub of queer activism, making the choice of venue bold and not without risks.
Before the conference began, “wanted” posters targeting alleged “trans foes” among the speakers circulated online, labeled with the phrase “know your enemy.” One poster featured Kathleen Stock, a British philosophy professor familiar with smear campaigns and death threats. Others included Tobias Banaschewski, Medical Director of the Clinic for Child and Adolescent Psychiatry and Psychotherapy in Mannheim, and Florian Zepf, Head of the Clinic for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy in Jena. Both, along with 13 other professors, had publicly criticized new guidelines for treating children and adolescents with gender dysphoria in German-speaking Europe. These guidelines deem psychotherapy “unethical” and prioritize puberty blockers and hormones. Experienced youth psychiatrists, however, consider this approach “dangerous.” As Professor Banaschewski stated: “It’s absurd to dismiss psychotherapy as conversion therapy and rely solely on medication and surgery, especially given the lack of scientific evidence that minors are better off long-term after medical transition.”
The conference explored youth gender distress through four lenses: evidence, etiologies, ethics, and psychotherapy. Among the alleged “fascists” and “right-wing extremists” were the President of the German Medical Association, who delivered a welcoming address, and the Chairwoman of the European Society for Child and Adolescent Psychiatry, who joined via video. In 2024, the German Medical Association passed a resolution calling for restrictions on puberty blockers. These credentials only seemed to fuel the anger of activists who advocate for countless biological genders, reject biological sex as a fact, and insist that every child requesting puberty blockers should receive them because their “gender identity” is innate
For security reasons, participants were advised not to photograph the venue, to exercise caution in public, and to avoid wearing identifying badges or discussing gender-related topics outside the conference hall. Twice, a deep, rumbling noise interrupted proceedings from outside. The first instance came from drumming demonstrators marching past, using the hashtag #transenemies_hasslethem. Those behind the “wanted” posters appeared ready to resort to violence. Citing the US Southern Poverty Law Center’s claim that SEGM is a “hate group,” demonstrators demanded the conference’s closure. SEGM rejects this accusation, emphasizing its focus on evidence-based care while acknowledging areas of uncertainty. As Professor Zepf, supported by Hannah Barnes, noted, medical decisions are ultimately binary: you either medicate or you don’t. Rational discourse is essential, but it should not lead to compromise on critical decisions.
The conference focused on therapeutic responses, potential psychological and developmental causes, and ethical considerations, aligning with SEGM’s scientific mission. Politics as a causal factor was only briefly addressed. Psychologist Lucy Johnstone discussed contradictions in psychiatric diagnoses, the pressures of neoliberalism (e.g., loss of family and community ties, income inequality, and the commodification of distress, where choosing a gender identity mirrors selecting a product), and the complexities added by identity politics. Linda Hart analyzed contemporary human rights discourse in pediatric medicine, noting that human rights are dynamic and contextual, with no binding right to self-identification. Efforts to frame “bodily autonomy” as a human right increasingly include consumerist preferences in medical services. Kathleen Stock addressed similar themes, critiquing a culture that celebrates autonomy, choice, and individualism, where saying “no” is seen as authoritarian “gatekeeping.” She highlighted the financial incentives tied to patient preferences.
The expanding concept of human rights was underscored by a second loud disruption: a convoy of motorbikes heading to Berlin’s Lustgarten to protest noise abatement regulations threatening bikers’ “human rights.”SEGM maintains a non-ideological approach to gender medicine, and participants agreed that the debate on evidence is largely settled. However, the role of politics in the rise of transgender identities cannot be ignored. The main organizer of the protests, the German Society for Trans* and Inter* Sexuality (dgti), a heavily taxpayer-funded non-profit, reflects this political influence. The German state continues to allocate millions of euros to trans-affirmative NGOs, advisory services, and school education programs.
Despite the increasingly hostile tone of transactivists, supported by the German Greens and their allies, the tide appears to be turning under the new conservative/social democratic government. Transactivists, who have consistently refused to engage in public debate as a matter of principle, are losing ground in the discussion around evidence-informed healthcare for children, adolescents, and young adults with gender dysphoria in Germany.
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