Children are not getting the care they deserve

In an article for The Washington Post, Laura Edwards-Leeper a founding psychologist of the first paediatric gender clinic in the United States, and Erica Anderson a psychologist and male-female transgender, express concern at how many health professionals do not follow the guidelines when it comes to providing care for transgender youth.

Both are members of WPATH (World Professional Association for Transgender Health) and are enthusiastic supporters of transitioning care for young people, but express that more comprehensive care should take place.

They claim that due to the skyrocketing number of young people seeking to transition, providers are wading into the realm of “sloppy, dangerous care” due to not following strict guidelines.

Providers and their behaviour haven’t been closely studied, but we find evidence every single day – from our peers across the country and concerned parents who reach out – that the field has moved from a more nuanced, individualised and developmentally appropriate assessment process to one where every problem looks like a medical one that can be solved quickly with medication or, ultimately, surgery.

Some US medical professionals working with children with gender dysphoria are even against the use of therapy for their patients, preferring to move them straight to medicalised treatment. Paediatrician, Dr Johanna Olson-Kennedy compares giving children opposite sex hormones – which are both unnecessary and harmful – to providing diabetic patients with life-saving insulin.

“We don’t actually have data on whether psychological assessments lower regret rates,” Johanna Olson-Kennedy, a paediatrician at Children’s Hospital in Los Angeles who is sceptical of therapy requirements and gives hormones to children as young as 12 (despite a lack of science supporting this practice, as well), told the Atlantic. “I don’t send someone to a therapist when I’m going to start them on insulin.”

Comprehensive assessments of gender dysphoric children are being neglected in favour of assumptions, while the children are passed from one provider to another. Social workers or counsellors often assume that medical health clinicians will carry out the assessments, while those same providers assume the referring social worker has already done it.

Edwards-Leeper and Anderson also claim “the overwhelming majority of those well-intentioned professionals receive limited or no training in the assessment of gender-diverse youth.”

In simple terms, the demand for competent care has outstripped the supply of competent providers.

Binary spokeswoman, Kirralie Smith, warned parents to take note.

“Parents are best placed to know what care has or has not been provided. They must insist that comprehensive assessments are performed for a sufficient amount of time before embarking on radical and often irreversible treatments for children,” she said.

“The evidence is increasingly clear, children who suffer from gender dysphoria have had trauma or other underlying psychological issues prior to the dysphoria that must be explored.

“Ultimately, doctors must be held responsible if these comprehensive assessments have not been carried out.”