Luke O’Reilly Kane reflects on the impact of puberty blockers and cross-sex hormones on her already delayed development, her experiences with medical transition and detransition, and the challenges of a very late sexual and emotional awakening.

I was developmentally delayed by about four years, but physically I was the opposite: bras at seven, first period at nine. Trans groups always say blockers are for “precocious puberty.” If my parents had known about them back then, would someone have put me on the same drugs? Thank God they didn’t.

Crushed

From about age seventeen, I had these crushes on girls, but it was never sexual: “She looks pretty, I like hanging out with her, she has nice hair, she’s cool to talk to.” Zero interest in sex or dating. Actually, I was doing everything I could to avoid it.

At twenty-one, after years on testosterone, I still had zero libido, which everyone says is the one thing T always does. I asked the doctor,

“Could this just be my delayed development?”

He said no, there might be “some estrogen sneaking in,” so we’d just raise the T dose.

Six months later, same problem: dose up again.

Another six months, age twenty-two, and finally, the gender clinic endocrinologist hands me puberty blockers.

I asked, “Won’t this mess with my already delayed development?”

“No,” he says. “Testosterone is your dominant hormone now. The blocker stops any leftover estrogen from getting through.”

I took them for nine months. They did nothing literally. I quit them myself, then, three months later, quit testosterone altogether after I tested genetically positive for hemochromatosis (a condition where your body stores too much iron and it builds up in organs and joints). I’d read that regular blood loss through periods is one of the main ways women naturally keep their iron levels safe, so I thought having my cycle back would be the simplest way to manage it. If the dysphoria got too much, I could always restart T. My broken voice and facial hair already gave me some confidence that there was nothing to worry about coming off testosterone. I could manage the fat redistribution with clothes as I did before T.

Three weeks after my natural estrogen returned, I finally knew what a libido was.

Awakening into Adulthood

Everyone says twenty-five is when adolescence ends. For me, twenty-six was when it finally started. Puberty at twenty-seven or twenty-eight is terrifying. The self-consciousness is brutal. At work, I’m constantly thinking I’m going to make a mistake so that someone trips, sues the company, and it will be my fault. In school, you just got told off or lost marks. Now the stakes feel life-ruining. Other twenty-seven-year-olds have been proper adults for years.

My manager says I’m a good worker, and perhaps in a few months I could become a supervisor. Part of me wants to climb higher and earn more, but I would also be responsible for ensuring that others don’t get into trouble. I’ve been working for over 7 years now. Have I done anything wrong?

Weirdly, this late sexual awakening is the first thing that’s ever made me want actually to live as my sex. I suddenly need to be attractive to the people I’m attracted to: women who like women. No amount of therapy, no counsellor, no TRA, no TERF ever gave me that. Both sides mostly gave me reasons to stay transitioned. Now I have a sense that’s bigger than ideology: I want a girlfriend.

Sex-ed in School and Youth Groups: Where Joy Goes to Die

Between eleven and nineteen, I heard way too much sex talk from adults: pregnancy, BDSM, kink, sex work, “different types of pleasure,” bodily fluids, all of it. It felt gross and wrong. There’s something seriously off about adults discussing that stuff in detail with kids and young teens. Basic biology would have been fine. The rest I wish I’d only ever talked about with my mum, at home, when I was actually ready. I wrote before: “You who gave me purpose to transition are the same ones who finally gave me purpose to leave it.”

Now I’m twenty-eight going on nineteen and terrified of hurting someone or doing life wrong. The feminists who scared me years ago—men and women both—they’re still in my head. All their talk of assault and abuse froze me in transition for years. After this massive late awakening, part of me wants to check out of the whole conversation forever.

Learn more about Luke’s story here.

Genspect publishes a variety of authors with different perspectives. Any opinions expressed in this article are the author’s and do not necessarily reflect Genspect’s official position. For more on Genspect, visit our FAQs.

Image: Trapped on the outside: photo by Eric Goverde

Protecting Puberty

To learn more about the importance of natural puberty, visit the Protecting Puberty website and sign Genspect’s Memorandum of Understanding on the Role of Puberty.

The post Sex, Lies and the Puberty Blocker Trial appeared first on Genspect.

The Professional Association for Transgender Health Aotearoa (PATHA) has self-published its “2025 Guidelines for Gender Affirming Healthcare” on Friday. These guidelines were contracted by Health New Zealand, recommend puberty blockers be given from ages 10 or 11, and still feature the Health New Zealand logo, but, following the 19 November restriction on new prescriptions of puberty blockers no longer reflect government policy.

“This conduct is reckless and misleading”, says Jan Rivers, spokesperson for Genspect NZ. “It invites the public to believe the guidelines retain official standing when in fact they do not.”

By independently publishing guidelines that contradict current regulations, while retaining the Health New Zealand logo on the front cover, PATHA is simultaneously rejecting government authority and claiming government credibility for itself.

If PATHA disagrees with the regulation, it is entitled to advocate publicly. What it is not entitled to do is blur the line between activism and the exercise of safe, regulated healthcare. The result is confusion, an erosion of trust, and a deliberate ambiguity about clinician accountability.

“The Ministry of Health must now act,” says Rivers. “Does the Ministry or Health New Zealand endorse any version of PATHA’s “2025 Guidelines” — yes or no? If the guidelines are not endorsed, the Ministry must say so clearly and publicly.”

PATHA has crossed a line by presenting rejected guidance as though it remains government-sanctioned. The Ministry must now restore clarity before further damage is done

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The New Zealand government is ignoring a growing international consensus about puberty blockers. The use of puberty blockers for gender distress is experimental, unproven and increasingly being restricted globally. Finland, Sweden, Brazil and the UK have already curtailed the use of these powerful hormonal interventions for children, but in New Zealand prescriptions continue at one of the highest rates in the world.

Jan Rivers, Genspect NZ spokesperson, states: “Gender-distressed children deserve evidence-based care. Overseas data show these drugs are not life-saving, do not improve mental health and risk irreversible harms. Releasing activist-written guidelines before independent data are available on outcomes would trash the regulatory safeguards meant to protect children. Children deserve better than guidelines that are little better than a drug-marketing brochure. This is precisely the sort of ideological treatment recommendation that our regulations are supposed to prevent.”

It is also deeply irresponsible for the media to repeat activist talking points that these drugs are ‘life-saving’. Such claims are unsupported by long-term evidence and downplay serious risks, particularly for minors. Oversimplifying complex medical interventions to produce emotive slogans does nothing to advance safe, ethical care.

Genspect NZ calls for:

1. An immediate, independent audit of every child already given puberty blockers.
2. A halt on new prescriptions until comprehensive outcome data are published and independently reviewed.

Health regulation exists to shield children from the harms of experimental treatment. The Ministry of Health must resist politicised pressure and uphold the principles of evidence-based medicine.

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Earlier this year, Genspect UK published a comprehensive report on the ethical and practical challenges faced by the NHS puberty blocker study. We concluded that those challenges were insurmountable, and wrote to the King’s College study team and the Health Secretary asking them to address the issues raised in our report. The replies we received were not reassuring. Our concerns were brushed aside, and there was no indication that those responsible for the study were grappling with the huge questions it raises.

Ethical Concerns Over the NHS Puberty Blocker Study

Despite news that the study design has now been submitted for final research approval, we seem no closer to hearing the answers to those questions. In fact, much commentary on the puberty blocker study seems to ignore them entirely, with discourse often breezing past the obvious moral complexities involved in interrupting healthy adolescent development. Recent comments by evidence-based medicine specialist Professor Susan Bewley, published on the Gender Clinic News Substack, are a case in point.

To her credit, Professor Bewley agrees with Genspect that it would be unconscionable to proceed with a new trial of puberty blockers before completing the data linkage study (DLS). Recommended by the Cass Review, the DLS would track the outcomes of the 9,000 children treated by the disgraced Tavistock Gender Identity Development Service. Some 2,000 of those young people are believed to have taken puberty blockers, and we must find out what has happened to them before we expose any more children to the well-documented risks of these drugs.

The Critical Need for the Data Linkage Study (DLS)

The total institutional malaise regarding the DLS has been incredibly disappointing to see. Despite the implications this may have for the ethics of any new trial of puberty blockers, Freedom of Information requests show that the DLS has occupied only a tiny fraction of the NHS Children and Young People’s Gender Dysphoria Research Oversight Board’s time. The Board has instead focused on advancing the new puberty blocker study as rapidly as possible. Health Secretary Wes Streeting, rightly praised for prioritising the safety of young people by introducing the puberty blocker ban, has given no public updates about when the results of the DLS may be available. It is hard to overstate just how irresponsible it would be for the NHS to proceed with a new puberty blocker study without taking account of what the DLS can tell us about the well-being of people who have already taken them. As Professor Bewley says, “I don’t see how they [the puberty blocker study team] can even be designing good research without that information.”

DLS aside, however, Genspect’s position on the puberty blocker trial diverges sharply from Professor Bewley’s. While Genspect believes that it would be unethical to conduct a trial at all, Professor Bewley argues that it would be unethical not to, stating that, “Other trials of more dangerous medications—for example, chemotherapy and radiotherapy for childhood cancers—have been ethical to test”. Professor Bewley doesn’t mention the critical flaw in this analogy. Childhood cancer can be fatal, and the risk-benefit analysis for any proposed treatment must account for the likely death of the child without medical intervention. By contrast, far from being fatal, gender related distress has remarkably high natural recovery rates. The acceptable threshold of risk is obviously far lower for a condition that is naturally remitting in the majority of patients. There is simply no comparison to be made between these two conditions, and given how much unnecessary fear has been caused by misinformation about gender distressed youth and suicide, public figures have a particular responsibility not to misrepresent gender related distress as a life-threatening condition.

Flawed Analogies and Methodological Issues

Still more puzzling are Professor Bewley’s beliefs about how the puberty blocker study could be made methodologically sound. So far, puberty blockers have not been tested in double blind, randomised control trials (RCTs), considered the ‘gold standard’ of evidence-based medicine. Double-blind RCTs aim to reduce bias by ensuring that neither participants nor study staff know who has been assigned to the intervention group or the placebo group. It should be immediately apparent that it simply isn’t possible to blind a study of puberty blockers. Children assigned to the placebo group will go through natural puberty, with all of the readily observable physical and emotional changes that entail, while their peers in the intervention group will not.

Bizarrely, Professor Bewley suggests this difficulty could be overcome by giving participants assigned to the placebo arm a fake puberty blocker injection. It’s not clear how she believes a fake injection could possibly conceal the growth of breasts and body hair, the start of menstruation, or the deepening voice. Common sense suggests that the trial will have been unblinded within a few short months of starting, thereby defeating the entire purpose of blinding in the first place. Professor Bewley tries to brush this off, claiming that “even if they [study participants] work it out later, this advances knowledge about the impacts of the drugs”. This is effectively an admission that no puberty blocker study, however it is designed, will be capable of producing the high-quality evidence that would be needed to justify the use of such a radical intervention on vulnerable young people. As Genspect argued in our report, it cannot be considered acceptable to expose more young people to the documented risks of puberty blockers simply in pursuit of further low-quality, inconclusive evidence.

The impossibility of conducting high-quality research on gender interventions points to the fundamentally subjective nature of both the diagnosis of ‘gender dysphoria’ and the beliefs people hold about how it should be treated. Professor Bewley suggests a list of research questions that the puberty blocker study might aim to address, but overlooks the fact that each is underpinned by the assumption that blockers are an appropriate and effective treatment. Questions about optimal dosing, the most beneficial age at which to commence blockers, and differences between young people with childhood or adolescent onset presentations all take it for granted that there is pre-existing agreement about the purpose of treatment and a clear indication for using risky, experimental interventions on physically healthy children.

Before quibbling over dosage and timing, we need to address the assumption that radically modifying children’s bodies in service of their ‘embodiment goals’ is an appropriate response to subjective feelings of mental and emotional distress. None of the existing research indicates that it is. Genspect’s report could not identify an evidence-based indication for the use of puberty blockers in gender distressed children, and the Cass Review itself “found that there is no clarity about the treatment aims of puberty suppression”. The impossibility of conducting truly objective research on this issue only makes it more critical that we tackle the complex moral questions posed by so called ‘gender affirming’ care, questions its’ advocates still have yet to answer.

It now seems almost inevitable that the NHS puberty blocker study will go ahead without ever substantively wrestling with those questions. A new cohort of gender distressed young people will be exposed to all the cognitive, emotional, and physical harms of blockers in the name of ‘research’, even though we can predict with some confidence that the study will not be capable of generating the decisive, high-quality evidence needed to break the deadlock on so-called ‘gender affirming’ care. Some of the young people who take part in the study will no doubt be harmed, joining the growing number of detransitioners for whom the NHS still provides no specialist healthcare pathway. In ten years’ time, when those young people are telling their stories in Genspect’s Beyond Trans support groups, people who supported the puberty blocker study will not be able to say that we didn’t warn them.

Carrie Clark is a writer and researcher in the UK. She runs the Healix Substack, a platform for people in the UK who have been harmed by prescribed psychiatric drugs, and works with the Inner Compass Initiative to raise awareness of non-pharmaceutical approaches to managing mental and emotional distress. She is a co-editor of The Gender Framework, an evidence based guide to understanding gender related distress.

Genspect publishes a variety of authors with different perspectives. Any opinions expressed in this article are the author’s and do not necessarily reflect Genspect’s official position. For more on Genspect, visit our FAQs.

The post Supporters of the NHS Puberty Blocker Study Are Still Missing the Point appeared first on Genspect.

My story feels timeless in parts—love, loss, the ache to belong, and the wild imagination of 15-year-olds dreaming of becoming someone else. But what sets it apart is that in my story, the adults were caught up in that same magical thinking.

One of the Boys

As a little girl with two older brothers, I wanted nothing more than to be like them. They were my idols, my inspiration, and my heroes in a lot of ways. I wore their hand-me-downs, listened to their music, and followed their every move. For a lot of young girls with brothers, this is pretty common. I loved being a tomboy and didn’t care what others thought. I was just me.

When I was five, my parents divorced, and my world flipped upside down. I wasn’t sure what would come next, but I just waited to see how life would change and hoped for the best — what choice did I have? Over the next few years, both my parents met new partners, and life was pretty different. I spent most of my time with my mom and her new boyfriend. They fought almost all the time. As an 8-year-old, this was hard. I felt like I didn’t have anywhere to go to escape the yelling. A lot of the time, he yelled at me. I never could figure out why, but it crushed me because I was doing everything I could to be a good kid, yet it never seemed like enough.

Then there was every other weekend at my dad’s house. My dad is amazing. If my brothers were my heroes, my dad was my superhero. He did so much to provide for me and my brothers, even when he wasn’t physically there. His new girlfriend, however, was not the same. Her kids were her everything; we, but we were treated as less than them. As an 8-year-old, I felt trapped and confused. I wasn’t even allowed to hug my dad around her because it made her jealous. It broke my heart to be pushed away from my dad and told, “not right now,” because she was nearby. She would even trick me sometimes by asking me something she knew I’d get wrong just so she could be right. My self-confidence at this point was nearing zero. All I ever tried to do was be a good kid. I was helpful, kind, quiet, and patient. Yet I was constantly being put down. Every day, I wondered, “What’s wrong with me?” I never felt normal or like I had a place I belonged. I didn’t know who I was or what it meant to be normal. I was lost.

A New Beginning

Fast forward to when I was 15. My mom decided to move us to a different state, four hours away, to be closer to my ailing grandmother. I started my sophomore year of high school in a different place and made new friends. It was a chance to reinvent myself. I decided to cut my hair short for the first time in years and spent the summer before school getting used to our situation, and making a lot of online friends. In retrospect, I was online far too much. With my short hair and more masculine look, I chose to label myself as a lesbian and started talking to girls romantically online. It seemed right. I felt a new confidence that I had never had before. I felt wanted and in charge.

The first day at the new school was nerve-wracking. Will I get lost? Will I meet people? Am I coming off weird? Where is my locker?! Even so, everything went well. I made one very good friend and felt so comfortable. Then, just a month in, I decided to join the Gay Straight Alliance club. I figured that being a lesbian it might help me make even more new friends. And it did! I went every week, and gained more and more friends! It was a great feeling. I got to know a couple of FTM trans people in the group, and as we became close, I started questioning whether I was supposed to be male. Were the difficulties in my life up to that point simply that I had been born in the wrong body? Was this the answer to all my problems? I decided it was.

I was 15 when I decided I was transgender, and I must have been my whole life. I borrowed a friend’s chest binder and started trying out new names at school. My friends at school love-bombed me; everyone was so excited. For once, I finally felt like I belonged somewhere. I felt special and on top of the world.

I told my family shortly after, and everyone was accepting but cautious. My dad wanted me to wait until I was 18 before getting any medical interventions, but my mom had full custody, so he couldn’t make any decisions. She was a little hesitant and wanted to make sure I was positive before making any permanent decisions. Looking back now, I realize that at 15, I could never really be sure, but I thought I was. I did my research; we went to a support group for trans kids and their parents, and I thought it was exactly what I needed.

The “Professionals”

I had to start therapy to get a letter for testosterone. I found someone who specialized in transgender care and arranged to see her right away. At our first meeting, she asked me.

“What are you here for?”

“I realized recently that I’m transgender, and my end goal is I’d like for you to write me a letter for testosterone,” I said.

She then told me, “We’ll need to talk about why you feel this way, over our next few appointments.” She explained that technically, by state law, I needed to see a therapist for 6 months before they could write me a letter, but told me, “I’m sure we can make it happen sooner.” Within a month, she had written me a referral letter for hormones.

I realize now that the speed at which I got that referral helped make me sure of my decision to transition. It happened so quickly that I didn’t have time to second-guess myself. It kept that high feeling of being special going. Everyone was affirming how special I was, so it must have been the right decision. Right?

Years later, I learned that this same therapist told my parents I would kill myself if they didn’t allow me to transition. She told my dad he had to get rid of or hide all the old pictures of me and never bring them up to me ever again. My parents were heartbroken, but they were just as brainwashed into thinking it was normal and what they needed to do as I was.

For the next 5 years, I lived my life as a happy male. I never got any surgeries, though I did take hormones. I truly thought I had made the right choice — even in my dating life. I met so many people who were attracted to me. I realize now that much of it was fetishized, but at the time, it kept me going. It was through this dating experience that I met my current boyfriend. He was different than the rest. We truly connected on so many levels. It was a love I’d never felt before.

Growing Pains

Through this time of growing up and growing closer with my boyfriend, I started to distance myself from the trans community that had been such a huge part of my life. It was then that the fog started to clear. As the people who constantly affirmed me disappeared, I felt less and less happy with myself. I started to struggle. Was I unhappy in our relationship? No, it definitely wasn’t that. But why was I feeling this way? I started to look at the hair covering my body; I didn’t like it anymore. When being intimate with my boyfriend, I felt gross. I was never ashamed of my female body parts, but the longer I was on hormones, the worse I felt about my body

At that point, I still believed I was male, but thought that maybe I didn’t need to take hormones. So I messaged the endocrinologist who initially prescribed testosterone me to ask if I could stop, if there were risks, and how to go about it. I said I wanted to start a hormonal birth control with my Primary Care Physician to keep my period away, and was told, “You should be fine to stop testosterone and start the birth control.” They didn’t even do blood work or see me for an appointment. When I expressed my concerns about going straight from testosterone to birth control with my PCP, she paused, shrugged, said it should be okay, and prescribed it

The next two years were some of the worst of my life. I took 2 different hormonal birth controls; I was depressed, anxious, and even suicidal. My doctor still did no blood work, even when I said how I was feeling. I was simply changed to a different formulation of birth control, which didn’t help at all. I was at my lowest point. I felt defeated. I hated myself. I hated what I had done to myself. I didn’t know if I was a male or female — or what. Nothing made sense. I was ruining my relationship with my boyfriend. I had so much self-hatred, everything made me upset, and our intimacy dwindled. Then, after almost a year, I decided to stop using birth control since I wasn’t able to be intimate, and my period had come back anyway. Within a week of quitting, I felt like a whole new person. My depression, anxiety, and self-hatred lifted almost immediately. It felt like a miracle! After spending years feeling miserable, it was just because of my hormones. Surely my doctors should have known and ought to have monitored me to make sure everything was going well. Yet none of them cared to even check on me. I was happy to have myself back, but devastated by the harm caused to my relationship. It made me angry, but at least I was able to start healing.

A Journey Home

Over the next couple of years, I rediscovered myself. I let my hormone levels even out naturally. I spent as much time with my boyfriend as possible to strengthen our relationship, and things got better. After some of the worst years of my life, I finally felt normal. Now, when I look in the mirror, I see myself, a “me” I’m comfortable seeing.

I hope others can learn from my story. For parents with kids going through this, I urge you to try to find the root problem of why your child is feeling the way they are. In my experience, there is always a reason. Adolescence is always a painful time. Some days, we want to grow up so badly that we hate the child we were. Others, we hate the adult we think others want us to be. The shock of divorce, moving, or some other trauma makes it even harder. Affirming a transgender identity enables that self-hatred and makes it “cool”.

II needed guidance and help from the people who should have been protecting me. I strongly believe that if my parents, my therapist, and the doctors I trusted had made me wait until I was in my 20s, I would have found myself naturally, without needing to change my body.

Despite the trauma I experienced on my journey — maybe because it was so hard to get through — I am stronger now than ever. I have a different view on life and can push through any troubles that come my way. I realize, too, how much my boyfriend’s love and support have mattered to me. Everyone needs to be loved, and I thank God every day for blessing me with such an amazing best friend and partner.

Photo by Hardcore Brain on Unsplash

Genspect publishes a variety of authors with different perspectives. Any opinions expressed in this article are the author’s and do not necessarily reflect Genspect’s official position. For more on Genspect, visit our FAQs.

Life Beyond Trans

Inspecting Gender is proud to feature the stories of detransitioners like Max C. We hope you’ll join Genspect at the Bigger Picture Conference in Albuquerque, September 27-28, to listen to Soren Aldaco on Digital Influence on Trans Identities, Cori Cohn on the Activist turn to Authenticity Over Evidence and Jonni Skinner on Detransition in Adulthood. Register now at genspect.org

Tickets selling fast – secure your seat now.

The post The Journey Back to Me: A Story of Detransition appeared first on Genspect.

“I’m glad that isn’t happening anymore.” My “normie” friend was remarking on the news that another hospital would no longer offer puberty blockers, cross-sex hormones, or surgeries to minors — she pays attention to that sort of thing now. I felt bad telling her it’s still going on, and just down the road.

In one sense, this was gratifying. I recalled her look of disbelief six years ago when I first explained the gruesome details of exactly what pediatric transition entails. It must have sounded outlandish at the time, but the steady drip of information in the interim, coupled with more coverage of the related issue of men in women’s sports and prisons, has made all the difference. More people sense something is wrong and are happy to see a change in course. The problem is that clinics are only a small part of the problem — just the tip of the iceberg. There is so much more lurking just below the surface.

Good News and Bad

First, the good news. In response to the Trump Administration’s executive order prohibiting hospitals from receiving federal funding if they provide so-called “gender-affirming care” to minors, a growing number of pediatric gender clinics around the country are closing. This includes LA Children’s Hospital’s Center for Transyouth Health and Development; Children’s National Hospital in Washington, D.C.; University of Chicago Medicine; Kaiser Permanente in San Francisco, and, most recently, Connecticut Children’s Medical Center. The threat of losing federal funding hits these institutions where they hurt.

The bad news is that this isn’t over — not by a long shot. In some ways, it is just beginning. Gender zealots will stop at nothing to keep medically transitioning kids. They will exploit any weakness in regulation or oversight. They will bend the law, and some are prepared to break it. How are they doing it? It starts with a cautionary tale from the UK.

Whither TERF Island?

Following the publication of the Cass Review report in April 2024, the UK’s National Health Service closed its Gender Identity Development Service (GIDS) and implemented multiple safeguards to protect children from irreversible medical procedures. At the time, it seemed like the beginning of the end of the medical scandal. It wasn’t.

The first blow came with NHS England’s announcement of the ill-conceived Puberty Blocker Study, which created a loophole that would allow clinicians to continue prescribing these drugs to children so long as they were part of the study. The next arrived last week when the High Court rejected a complaint against the licensing of Gender Plus Healthcare, a private clinic set up by former Tavistock clinicians (read more here).

It turns out that private clinics, regulated by the Care Quality Commission (CQC), can operate without the rigorous standards of the NHS and, as was the case with Gender Plus, receive an “outstanding” rating so long as they adhere to the technical requirements of the CQC. This meant Gender Plus, which was set up by former GIDS clinicians, could carry on operating in the same reckless way they always had, as if the NHS reforms had never happened.

The Wild West

While the UK grapples with loopholes created by private clinics, the United States faces an even more troubling landscape due to its decentralized healthcare system and varying state laws. This patchwork of regulation creates a “Wild West” environment where activists and providers exploit gaps with greater ease.

Clinics in the United States are licensed at the state level and operate in accordance with local laws. This means that, unless specifically prohibited, those with enough money to pay out of pocket—or whose insurance plans cover gender procedures—may obtain puberty blockers, hormones, and surgeries. While 27 states have passed bans or restrictions on transition for minors, loopholes persist.

For instance, providers in some of these states have exploited grandfather clauses that allow them to continue treatment for patients who were receiving treatment before the bans took effect. In other states, Arkansas, for instance, clinicians rushed to initiate treatments with minors before their state’s ban was enforced. Other places have focused on providing services like mental health counseling or primary care, which are not prohibited. They then refer their patients to providers in permissive states like California or Minnesota, where medicalization is still legal. Another potential loophole exists in states with exemptions for “medically necessary” treatments, such as the use of puberty blockers for conditions like precocious puberty, written into their legislation. An increase in the number of cases of such conditions might be overlooked without robust regulatory oversight.

While many telehealth providers (Folx Health, Plume, Planned Parenthood) claim they do not provide hormones to those under 18, a minor who is legally “emancipated” (i.e., a teenager who is legally freed from parental control and supervision) can, with proof of their status, seek cross-sex hormones from online providers in trans sanctuary states such as New York. For minors in states with bans, nonprofits and charity care programs like Trans Youth Equality Foundation offer advice and sometimes funding to travel to permissive states where they can transition.

Outlaws

Rogue providers may use illegal or ethically questionable methods to circumvent bans. In March 2022, Texas Children’s Hospital (TCH) announced it would stop gender-affirming hormone therapy for minors after Texas cracked down on the practice. Dr. Eithan Haim then a medical resident, discovered that a colleague had inserted a hormone-releasing implant into the arm of an 11-year-old girl after TCH’s announcement. The procedure was likely disguised as treatment for an endocrine disorder to skirt the ban. Dr. Haim discovered that the frequency of such procedures rose drastically after TCH’s announcement, indicating that potentially hundreds more children received such interventions for gender dysphoria. Providers making use of similar mislabeling or off-record prescriptions risk felony charges and up to seven years in prison, but some, like those at TCH, are willing to take the risk.

The Biggest Loophole of All

The phenomenon of “trans sanctuary states” like California, Minnesota, Washington, and New York poses a significant challenge to enforcing restrictions on pediatric gender interventions in the United States. These states have enacted laws, such as California’s SB 107 (2022), that protect access to puberty blockers, cross-sex hormones, and surgeries for minors, and shield families and providers from out-of-state legal actions when they have sought treatment in-person across state lines. Should minors run away to such a state, a network of charities, social services, and NGOs is only too happy to facilitate their transition, as this recent exposé of organizations in New York City reveals. If things are allowed to continue as they are, the United States will Balkanize into regional hubs where anything goes, and everyone else.

ICE BERG, RIGHT AHEAD

While the leadership of the Trump administration has been transformative, it is not enough. Even victories in state legislatures are subject to the vagaries of politics, with no guarantees that governors will sign bills restricting bans on pediatric transition into law. So, how do we right the ship? Here are a few ideas.

Consistent Oversight

In the UK, ensuring consistent oversight requires reforming or replacing the Care Quality Commission (CQC) to prioritize medical expertise over regulatory specialization. The body regulating private clinics must base its oversight on a deep understanding of medical practices, particularly for treatments like puberty blockers, hormones, and surgeries for minors, to ensure patient safety and evidence-based care. In the US, consistent oversight demands a unified federal policy to address the disparities created by varying state laws.

The Trump Administration’s executive action targeting federal funding for these treatments is a step forward, but it was unable to regulate private clinics, which may operate independently of federal funding. A federal ban on pediatric use of puberty blockers, hormones, and related surgeries by Congress would face legal challenges, with opponents citing states’ rights and medical autonomy. However, the recent United States v. Skrmetti (2024) ruling, which upheld Tennessee’s restrictions on these treatments for minors, suggests that activists’ arguments are often weak and lack robust legal grounding, making the case for a federal policy a debate worth pursuing.

Targeting Fraud — Of All Kinds

To deter rogue providers, stricter penalties should target mislabeling or falsifying records for treatments like puberty blockers and hormones for minors, as seen in the 2023 TCH case, where providers allegedly skirted state bans. Strong whistleblower protections are vital to encourage healthcare workers to report violations safely. Federal audits must focus on states with lax telehealth or private clinic oversight to enforce compliance with bans. Consumer fraud is another important arena. The FTC’s 2025 workshop on The Dangers of “Gender Affirming Care” for Minors highlights a path forward that enables investigations into providers who mislead families about the safety or necessity of treatments under existing consumer protection laws. Citizens should be empowered through anonymous online portals, dedicated hotlines, and advocacy group partnerships to report abuses.

Public Awareness

We must never underestimate the importance of public awareness. Lifting stories of detransitioners, whistleblowers, and evidence from the Cass Review, the recent HHS review, so that people can follow debates, can shift public opinion and pressure lawmakers to scrutinize claims about the efficacy of puberty blockers and hormones for minors. Such reviews, which highlighted gaps in evidence for these interventions, should be required reading for public servants engaging with families—including teachers, social workers, police, healthcare professionals, and judges—to ensure informed, evidence-based decision-making.

Just Tell the Truth

It occurred to me that my friend might not have paid attention to the clinic closures if I hadn’t risked sounding like a card-carrying conspiracy theorist six years ago. Her relief is good because it means that skepticism of pediatric transition is starting to become mainstream, but the undercurrents of activism and loopholes mean the course correction is only beginning. “That” is still happening. Lasting progress will require vigilance, stronger regulations, and open, honest debate.

Join Genspect at The Bigger Picture conference in Albuquerque, New Mexico, September 27–28, 2025, for an unflinching look at how far we’ve come and we need to do to make lasting change. restore it.

Tickets selling fast – secure your seat now!

The post Closing Clinics and Loopholes appeared first on Genspect.

On Wednesday July 9th, parents, detransitioners, clinicians, legal professionals, and others gathered with the Federal Trade Commission (FTC) in Washington, DC, for an all-day workshop on “The Dangers of ‘Gender-Affirming Care’ for Minors.” Nestled deep in the Congressional Center, the event lacked the fanfare of a legislative hearing or the pomp of the West Wing, but it felt portentous. Why? Because, while many of us have understood from the beginning that trans medical procedures are harmful, it appears that they are also illegal under existing consumer protection laws. Now, under the auspices of the Trump Administration, the FTC is set to exercise its authority under Section 5 of the FTC Act to investigate deceptive claims about the safety and necessity of puberty blockers, hormones, and surgeries

.

The Federal Trade Commission (FTC) is an independent agency of the U.S. government that focuses on protecting consumers from fraud. Through a combination of antitrust enforcement (preventing monopolies and other unfair modes of operation) and guarding the public against fraudulent, deceptive, and unfair business practices, they are the government men and women, or “G-Men,” who, when empowered to act, tirelessly champion ordinary citizens, safeguarding the little guy against corporate greed and organized deceit.

There was a palpable sense of relief in the room when Andrew N. Ferguson, Chairman, Federal Trade Commission, took the stage. He began by recounting how the Biden administration pressured the World Professional Association for Transgender Health (WPATH) to remove age-minimum requirements for cross-sex hormones and other sex-change surgeries from their Standards of Care 8 guidelines on care of transgender youth. “The Biden Administration’s concern,” he explained, “was not that age-minimum requirements were unscientific, unreasonable, or unhelpful to doctors, therapists, parents, and children experiencing gender dysphoria.” Science wasn’t the point. They worried that “age-minimum requirements gave too much ammunition to critics of ‘gender-affirming care.’”

He went on:

Today is not about politics. It is about the parents and kids the Biden administration chose to ignore. It is about our nation’s children, who stand in most need of our love, protection, and support. It is about their parents, whose selfless and fruitful love is the foundation of our nation and every nation. It is about caring for the most vulnerable among us and protecting them from manipulation and abuse. It is about healing the wounds that proponents of gender-affirming care may have inflicted on our nation’s children and parents and preventing the potential for future harm. Today is going to be about people, not politics.

There’s a New Sheriff in Town

This moment has been a long time coming for the parents of children who were asked by the clinicians they trusted, “Would you rather have a live son or a dead daughter?” And for the medical professionals and scientists who knew that the claims being made weren’t adding up; for the whistleblowers who paid the price for exposing their employer’s fraud; for the lawyers who stepped back from lucrative practices to take on the lawsuits of the people harmed by puberty blockers, cross-sex hormones, and surgeries. Most of all, it was a significant moment for the detransitioners who live with the grave consequences of the experimental medical procedures they received in the name of identity affirmation. Many of the individual stories shared were familiar.

There was Prisha Mosley, the detransitioned woman who suffered excruciating pain when the remnants of her breast tissue from a “gender-affirming” mastectomy began producing milk within her chest after she gave birth; Claire Abernathy, whose breasts were removed in the summer after her 8th grade graduation; Soren Aldaco, who was prescribed testosterone after a short appointment; Elvira Syed, the mother whose medically transitioned daughter’s body lay undiscovered for days in her college dorm room after she committed suicide, while her dorm mates celebrated “Coming Out Day.” The horror of their experiences is not new. Even so, there were many moments when the audience, most of them veterans in the struggle against gender quackery, gasped at some of the details. The difference now is that the G-men are firmly on the case.

The Untouchables

Much like the IRS’s game-changing pursuit of mobster Al Capone for tax evasion in the 1930s, when his violent crimes proved untouchable, the FTC is leveraging its authority to investigate deceptive claims about the safety and necessity of puberty blockers, hormones, and surgeries. Chairman Ferguson compared purveyors of so-called “gender-affirming care” to the snake oil salesmen of old who exploited the desperation and pain of vulnerable people for financial gain.

Not only does the FTC have jurisdiction in this area—the FTC has brought dozens of enforcement actions against false and misleading health claims by pharmaceutical companies, manufacturers of supplements, and clinics purveying unproven treatments like stem cell therapies—but “it is the Commission’s duty to protect American citizens” from potential consumer harm.

Confronting Big Gender

The event was an opportunity to reflect on the last decade, during which gender practitioners and ideologues have been allowed to run wild. Dr. Miriam Grossman began the workshops by speaking on the dangerous normalization of language, in terms like “sex assigned at birth” or “gender-affirming care,” and the potentially deadly obfuscation of sex in health care settings.

Then it was on to the panel on the corruption of science, where we learned about how safeguards like peer review and the declaration of conflicts of interest have been compromised. Circular citations and unpublished systematic reviews are just the tip of the iceberg. Leor Sapir spoke about the broken chain of trust and argued that the people who least deserve blame for the harms inflicted by the gender industry are the parents and medical professionals who assumed good faith on the part of so-called experts.

Other highlights included:

• The panel of whistleblowers who described how and why they pushed back when asked to transition minors and the price they paid for speaking out.
• The final eye-opening panel, which identified key areas in which the FTC should act, such as holding medical associations to account for deceptive claims and guidelines, and other creative tactics, such as educating the judiciary on the deficiencies of the guidelines they have deferred to.
• Genspect board member Erin Friday’s (a.k.a. Erin: Warrior Queen) inventory and rogues’ gallery of the worst offenders in the Gender Industry. (below)

Watch the workshop here

How You Can Help

The Commission intends to issue a public request for information on the various topics covered in the workshop. Inspecting Gender will share the details when they become available — and we will be sharing what we have learned in the course of our work.

Image: Commissioner Andrew —Elliot Ness—Ferguson, the “g-men” of the FTC

A New Era Begins

Join Genspect at The Bigger Picture conference in Albuquerque, New Mexico, September 27–28, 2025, where we’ll explore the implications of the new climate around gender in the United States, what we’ve learned and what we need to do now. Register now at genspect.org

Tickets selling fast – secure your seat now.

The post The G-Men Cometh appeared first on Genspect.

From 1995 to 2016, a period spanning over two decades and thousands of patient encounters, I did not meet a single transgender-identified young person. Today, I may encounter several transgender-identifying adolescents in a single afternoon clinic. My experience aligns with epidemiological trends, which show an exponential rise in transgender identification.

This surge in gender-related distress among young people runs parallel to an unprecedented integration of technology into daily life, fundamentally altering how information is consumed and how young people socialize and learn. Chaukos-Bradley and colleagues (2022) describe this as a “perfect storm” fueled by the mutual uptake of smartphones and social media. The “phone-based childhood” disrupts development by focusing young people on social comparison and appearance, and amplifying sociocultural pressures.

Narcissus Stares into a Smartphone

Through most of human history, appearance preoccupation would be impossible as a still pool of water was required for a brief glimpse at our reflections. From ancient obsidian mirrors to the invention of glass mirrors in 1835, technological advancements slowly allowed humans more opportunities to view themselves. In stark contrast, widespread adoption of both smartphones and social media provided two simultaneous and profound technological advances. All at once young people had easy access to a flood of self-referential images, online pornography and a previously impossible degrees of social comparison. Particularly among girls, pressures to be “camera-ready”, combined with algorithms, filters, and amplification effects sculpted widespread body dissatisfaction and increased depression and anxiety. Just at this time was the large increase in transgender self-identification and associated transgender–related ideologies including:

• Infiltration of Dysfunctional Ideologies: Post-modern and anti-scientific ideologies seeped from academia into society, promoting narratives such as oppressor-victim binaries, disregard for traditional labels and boundaries, and an excessive focus on personal identity.
• Indoctrination Techniques in Schools: Techniques like brightly colored “gender unicorns” and requests for “preferred pronouns” exposed children to campaigns to displace traditional understandings of sex and sex roles. Schools normalized concepts like “gender identity” (the idea of a gendered soul) and the belief that humans can change sex (e.g., “trans women are women”) or could be born in the wrong body.
• Lack of Nuanced Discussion on Sex and Sex Differences: There has been significant resistance from both political left and right to openly acknowledge humans are a sexually dimorphic species. Acknowledging this reality could have helped to undermine dysfunctional theories about human sexuality and identities. Instead, transgender ideology has conjured up theories regarding oppressive regimes of “cisnormativity” and demanded that society ignore humans’ evolved sex differences and the sex binary.

The Medical Perfect Storm: The Placebo Effect and “Affirmative Care”

Unfortunately, at a time when the medical and mental health establishments should have been a bulwark against developmentally inappropriate and unscientific theories sweeping through society, they were experiencing their own “perfect storm.” As detailed by Clayton (2022), the second perfect storm was the development of a widespread belief that medical treatments (puberty blockers, hormones, and surgery) were the optimal solution to youth gender-related distress.

This belief in gender-affirming treatment was bolstered by

• A poorly considered loosening of diagnostic labels in 2013.
• A reasonable desire to help gender non-conforming young people.
• Clinicians’ desires to be seen as compassionate advocates.

However, the gender-affirming care movement would not have swept through medicine were it not for clinicians confusing placebo effects with genuine treatment effects. Placebo effects encompass a range of non-specific factors, primarily patient expectations and clinical relationships. The surge of enthusiasm from Gender Affirming Care (GAC) providers and within the broader culture maximized these placebo effects, especially given the framework that patients “know” their gender identity and require “life-saving” and “evidence-based” surgical and hormonal treatment.

While a small number of adults throughout history have had a persistent desire to be the opposite sex, gender dysphoria was formerly a rare medical and societal curiosity. Despite a lack of robust evidence, a narrative was promoted that hormones and surgical treatments were evidence-based, ethical, and lifesaving. This viewpoint is contested in adults, but until two decades ago, doctors had been sensible enough to avoid calling children transsexual. The name change from transsexual to transgender was in part to make it easier to apply this label to gender non-conforming children.

Highly flawed observational retrospective “research” from the Netherlands portrayed a regimen of puberty blockers, hormones and surgeries as experimental, but effective treatments. In the 2000s and 2010s, enthusiastic clinicians spread this approach worldwide. This “runaway diffusion” in pediatric gender medicine was aided by a social justice movement stigmatizing other approach and adopting civil rights language. Traditional media, social media companies, left-leaning political organizations, government bureaucracies, universities, and medical societies all tossed aside skepticism to appear virtuous and supportive. Transgender advocates were allowed to craft institutional policies, giving gender affirming ideologies authoritarian control over important bureaucracies and institutions.

Clayton (and others) have noted that this affirmative model of treatment was promoted throughout medicine in an unusual manner, characterized by:

• Excessively Negative Portrayal of Alternatives: Previous standard treatments and current alternative options were demeaned, such as labeling watchful waiting as outdated and stigmatizing psychotherapy as “conversion therapy.”
• Exaggerated Suicide Narrative: An exaggerated suicide narrative was used to pressure parents, other clinicians, and communities to accept opposite-sex identification. Reasonable parents would only agree to such drastic treatments for a socio-culturally created problem if they were bullied by claims that hormones and surgeries reduce a very high suicide risk.
• Framing as Civil Rights: Hormonal and surgical treatment was framed as civil rights, elevating “gender-affirming” providers as ethical and heroic.
• Stigmatizing Other Approaches: Those who preferred other clinical approaches were stigmatized as “anti-trans,” and gender-affirming treatments were presented as the only option at gender clinics.
• Concerted Promotion Efforts: Organized and concerted efforts were made to have medical societies, universities, government bureaucracies, clinicians, and activists promote gender-affirming treatments.
• Biased Research: Clinicians already employed in gender-affirming care conducted observational research to confirm their pre-existing belief that this care is ethical and effective. This is precisely the short-term, uncontrolled, and patient self-report-based research most likely to capture placebo effects. The results of these low-quality studies were then used to justify continuing and expanding gender-affirming treatments.
• Hostility Toward Those Who Raise Concerns: A long list of clinicians, researchers, and even gender-care specialists have been attacked for expressing caution. These attacks have been fueled by social media-inspired and online campaigns, which transformed academia into a space replete with ideology, ad hominem attacks, moralization, and witch-hunts.

Only over time did the more skeptical medical and mental health community call for systematic evidence reviews. These reviews have repeatedly indicated that little is certain about outcomes, and even the short-term effects of gender-affirming care are underwhelming. When positive effects are observed, they are small enough that placebo effects would reasonably explain the minor gains.

Medical professionals are expected to be mindful of placebo effects, conflicts of interest in research, and the potential harms of overtreatment. Yet Western medicine, especially in the United States, has a propensity for naive interventionalism. We have a medical system biased toward action rather than reflection, particularly when the “treatment” creates new profit centers.

For dissatisfied young people, adopting an “illness identity” can provide a sense of self and belonging in a fragmented and rapidly changing world. Yet adopting an illness-based identity carries the risk of defining oneself through a diagnosis. In the case of youth gender medicine, it carries the additional harms of destroying healthy body parts and adopting a fundamentally false belief about oneself.

As Clayton noted, “A medical profession that does little to distinguish placebo effects from specific treatment effects risks becoming little different from pseudoscience and the quackery that dominated medicine of past times, with likely resulting decline in public trust and deterioration in patient outcomes.”

Kris Kaliebe is a psychiatrist and educator who explores how social media and cultural pressures are impacting young people’s mental health.

Watch Dr Kalibe’s talk at the Lisbon Bigger Picture Conference here.

Photo by camilo jimenez on Unsplash

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So, you might very well ask: why on earth do we need a Memorandum of Understanding to Protect the Role of Puberty in Adolescent Development? It sounds absurd, doesn’t it? But in today’s upside-down world – where we have to go all the way to the Supreme Court to establish that men aren’t women – we’re forced to defend the most basic biological facts and fundamental realities. It’s a mind-melting, maddening waste of time and energy. And yet, if this is what it takes to stop harmful medical experimentation on children’s bodies, then count me in.

The Memorandum of Understanding on the Role of Puberty in Adolescent Development does two things: it safeguards the crucial role of puberty in adolescent development and it highlights the responsibility of adults to protect children. Genspect has made the MoU available on this website where organisations and parent groups from around the world can sign up, download the compliance badge, and display it on their own sites and social media to show that they are informed, engaged, and committed to protecting children and teenagers from avoidable harm. We’ve also issued a Statement of Concern that applies the MoU’s principles by opposing the proposed NHS puberty blocker trial. Individuals can sign this statement and have their names displayed on the website.

Puberty is not an optional stage of development; it is a remarkable and transformative process. More than a biological milestone, it is a profound experience that helps shape our adult identities. While a small number of individuals with Differences of Sex Development (DSDs) may not undergo puberty in the typical way, these rare exceptions do not diminish the critical developmental importance of puberty for the vast majority of children and adolescents. The cognitive, emotional, physical, sexual, and social changes it brings are still not fully understood – a testament to the complexity and dynamism of this pivotal life stage.

At ten years old, most children are still immersed in their immediate world – thinking about fun, sweets, Mammy, Daddy, their friends, and upcoming treats. As they begin to mature physically, sexually, and cognitively, their capacity for more expansive thinking grows. By their early twenties, they have typically emerged as fully-fledged adults, with a far more nuanced understanding of themselves and the world around them.

When a child is put on puberty blockers, it is not only their sexual development that is halted; their entire developmental trajectory is disrupted. They do not experience a sexual awakening, nor do they go through a romantic one. While their peers are navigating first crushes – just as young children play at house, teenagers play at love – these essential developmental rehearsals are missing. Yet it is through these early, often awkward experiences that we prepare for one of life’s most fundamental evolutionary tasks; to form intimate bonds and, ultimately, to reproduce.

Of course, some adults will choose not to reproduce, and others may be unable to, but puberty lays the biological and psychological foundation that makes this choice possible in the first place.

The loneliness of being human often strikes with full force during adolescence; this is when a young person first begins to feel the deep yearning to fall in love. It’s no wonder so many adolescents turn to poetry, music, and art for comfort. As the brain becomes more complex, teenagers confront their aloneness and embark on the long, often difficult search for a mate – a search that underpins our most fundamental human drives.

The first-love relationships that teenagers experience further complexify the mind as they begin to realise that they can love someone and hate someone at the same time. Few of us remain simplistic once we have experienced the pain of unrequited love – and for most, this rite of passage typically takes place during adolescence.

But none of this is open to the puberty-blocked teenager. Instead they remain frozen in a childlike state. Like Peter Pan, they are happy to have friends and go on adventures, but they don’t experience any deeper yearnings to find a mate or to grapple with life’s more profound emotional questions.

The Experimental Medically Constructed Adult

Puberty is a complex developmental cascade driven by the activation of the hypothalamic-pituitary-gonadal (HPG) axis. This intricate system initiates the maturation of reproductive organs, the development of secondary sex characteristics, the onset of fertility, and profound physical, neurological, and emotional transformations.

When a young person whose puberty has been suppressed reaches the age of 18 and moves on to cross-sex hormones – as approximately 98% do – they become what can only be described as an experimental medically constructed adult. Having bypassed natural puberty, their entry into adulthood is pharmacologically induced rather than biologically emergent.

Although some people with rare medical conditions may not go through typical puberty, never before in human history have people reached adulthood without undergoing some form of pubertal development. But this is now changing.

Puberty-blocked individuals undergo a chemically induced facsimile of puberty – a kind of partial sexual awakening disconnected from the natural maturation of their reproductive systems. For example, a teenage girl given testosterone may develop an increased libido, but because her ovaries, uterus, and other reproductive structures have not matured, the experience is largely pharmacological and not integrated into a fully developed adult body. It is a chemical reaction, not a holistic biological transition.

This startling example of medical technology offering bioengineered options may excite overzealous clinicians like Norman Spack – who has more than once described himself as “salivating” when he first heard about puberty blockers – but it is not good for humanity.

Facilitating meetings with detransitioners who never went through puberty has given me deep insight into the risks associated with these radical interventions. Through the Beyond Trans programme, I often meet female detransitioners who skipped puberty and are now fearful of reverting to their biological sex. Those who have undergone a hysterectomy or a bilateral orchiectomy are particularly fearful of reverting, as this would entail reintroducing a sex hormone into a body that never experienced natural puberty and no longer contains key reproductive organs.

These are experimental interventions, and we have yet to see the long-term outcomes for detransitioners who are now facing puberty in adulthood. Will the body fully “know” what to do with oestrogen or testosterone in this context – without reproductive organs and without the developmental groundwork laid during adolescence? We still lack long-term data. These detransitioners are understandably wary of further experimentation on their bodies and often feel forced to continue presenting as trans – despite deep regret – because they believe they have passed the point of no return.

The Case for Protecting Puberty

The MoU on the Role of Puberty in Adolescent Development affirms rights set out in the United Nations Convention on the Rights of the Child (UNCRC, 1989), a legally binding treaty ratified by 196 countries. At its core, the MoU emphasises the protection of a child’s right to an open future – a principle it argues is undermined by the medical transition of minors experiencing gender-related distress. This position aligns with key articles of the UNCRC:

• Article 6(2) mandates the protection of “the survival and development of the child.” Puberty blockers disrupt essential developmental processes crucial for maturation into adulthood.
• Article 19(1) obliges states to shield children from harmful practices such as “injury or abuse” Medical transition is associated with significant risk of harm to the body, including reduced bone density, potential adverse impacts on brain development, and compromised fertility.
• Article 24(1) affirms the child’s right to “the highest attainable standard of health.” Medical transition violates this principle by transforming previously healthy children into lifelong medical patients.

The MoU advocates for non-medicalised support that upholds the UNCRC’s fundamental commitment to protecting children’s health, well-being, and development.

We’re delighted that all the leading organisations who are informed about the harms of medical transition recognise the vital role that puberty plays in adolescent development and have already signed the MoU. Groups such as Sex Matters, Can-SG, Transgender Trend, Our Duty, Thoughtful Therapists, Critical Therapy Antidote, LGB Alliance, and many others have all declared their support. Key figures in the field have signed the Statement of Concern, including Prof David Bell, Dr Az Hakeem, Marcus and Sue Evans, Dr Stephen Levine, Sasha Ayad, Dr Louise Irvine, Dr Stella Kingett, Dr Jillian Spencer, James Caspian, Bob Withers, James Esses, and Prof Dianna Kenny.

We invite all organisations to display the MoU compliance badge to publicly demonstrate their commitment to protecting children and adolescence. Organisations wishing to feature their logo on the MoU website can email info@genspect.org for consideration.

Throughout this process, we have become aware of certain groups and organisations within our movement who believe that further studies are needed before taking a firm stance. But having spent years examining the evidence, we do not believe this is a tenable or ethically defensible position.

Tragically, some gender-critical clinicians and academics – despite their concern about puberty blockers – still cling to the idea that some children may benefit from skipping puberty. It is the early-onset gender-dysphoric children who remain most at risk from this viewpoint. These are the tomboys who came out of the womb with a swagger and a boyish strut; the feminine boys who squeal with joy as they twirl in their princess dresses.

It is almost unfathomable that, after all the books, articles, podcasts, films, webinars, and conferences, there is still uncertainty about puberty blockers. What astonishes us most is that even within our own movement, clinicians and academics still wring their hands and ask, What should we do? But there it is – too often, strategy and careerism outweigh principle.

While others continue to believe they can somehow play God in the lives of vulnerable children, those who have signed the MoU are drawing a clear line. These medical interventions on children are deeply harmful and should be banned. The jury is in. We don’t need more medical experiments on children. We no longer need to apologise for holding this position, and it no longer matters that zealots try to shame us by calling us transphobic. Sometimes, doing the right thing must come before appeasing the mob.

Puberty is the essential bridge between childhood and adulthood. We must protect every adolescent’s right to cross it, so they have the best possible chance at a healthy and free future.

To be considered for inclusion in the movement to protect puberty in adolescence, visit the new MoU website, download the compliance badge, and email info@genspect.org to add your signature.

The post Why We Must Protect Puberty<br> <span style='font-size: 50%; line-height: 1;'>How Genspect’s Memorandum of Understanding is rallying a global movement to defend healthy adolescent development</span> appeared first on Genspect.

Imagine a teen arrives at the mental health unit where you work. Once they are settled, you sit down to talk about what is bothering them. Some stay quiet, others mention a specific issue, and a few even know what they need to do next. Usually, they only have a vague idea of what is wrong, so together you start figuring it out—step by step. That is how therapy often begins.

But things are different with teens who feel uncomfortable with their gender, a condition called Gender Dysphoria. Since cases spiked in the late 2010s, the approach has shifted. Now, when these teens say their struggles come from Gender Dysphoria, staff often accept it without much question. Instead of exploring other possibilities, therapy centers on agreeing with their belief and moving toward gender-related solutions. This “affirm-first” style clashes with how we usually help people in mental health care.

Normally, we follow a clear process: build trust, assess what is going on, make a plan, try it out, and check if it works. We call this the Nursing Process—Assess, Plan, Implement, Evaluate. A key part of assessing is “Watchful Waiting,” where we observe and learn about the teen’s struggles without jumping into big treatments. Yet, with Gender Dysphoria, this step is often skipped or barely touched.

What Is Watchful Waiting?

Watchful Waiting means keeping a close eye on someone’s health without rushing into major treatments unless they are urgently needed for safety. It is used when starting treatment might cause more harm than good. For teens with Gender Dysphoria, it is not about pushing them to accept or reject their gender feelings. Instead, it is a neutral way to explore what is really going on—over time—while offering proven help for any other mental health challenges, like depression or anxiety, which often show up alongside Gender Dysphoria. It is a slow, steady way to understand the whole picture, backed by professionals who value careful assessment over quick fixes.

Why Watchful Waiting Helps

1. Gives Time to Understand the Full Story
   Teens with Gender Dysphoria often deal with other issues—think depression, anxiety, autism, trauma, or low self-esteem. Watchful Waiting lets us spot and treat these first. Some even argue Gender Dysphoria acts like the “new anorexia,” influenced by trends among friends or online.
2. Avoids Rushing into Permanent Changes
   Starting gender treatments—like hormones—can lead to lifelong effects. These include weaker bones, mood swings, weight gain, heart risks, infertility, and even changes in brain function. Waiting helps avoid regrets from choices that cannot be undone.
3. Lowers the Chance of Mistakes
   In places like the UK’s Tavistock clinic, rushed assessments led to wrong diagnoses. A neutral, careful approach prevents that.
4. Reduces Peer Pressure
   Studies show some teens feel pushed toward identifying as transgender by friends or social media. Waiting gives them space to think for themselves.
5. Supports Natural Growth
   Most kids who question their gender eventually feel okay with their birth sex if given time and neutral support—no pushing either way.
6. Brings Families Together
   Parents are a teen’s biggest allies. Waiting opens up honest talks and builds trust over time.
7. Builds Confidence
   Rushing into gender changes and then regretting it can hurt mentally. Exploring all options first helps teens feel surer of who they are.

Real Risks, Real Regrets

Gender treatments—like puberty blockers or hormones—carry serious side effects: infertility, heart problems, even brain tumors in rare cases. Stories like Keira Bell’s, who sued a clinic for rushing her into treatment she later regretted, show why slowing down matters. Her case sparked the 2024 Cass Review, which calls for change.

A Safer Way Forward

Today’s quick-to-affirm approach skips the careful steps mental health care relies on. Watchful Waiting puts assessment first, keeping teens safe while they figure things out. With growing evidence and reviews like Cass pushing back, it is a practical, thoughtful way to help.

Jason Watson is a New Zealand Registered Nurse who has dedicated 18 years of his 40-year career to working in Child and Adolescent Mental Health settings.

Genspect publishes a variety of authors with different perspectives. Any opinions expressed in this article are the author’s and do not necessarily reflect Genspect’s official position. For more on Genspect, visit our FAQs.

The post Why We Watch and Wait appeared first on Genspect.