The Real Scandal in Trans Youth Healthcare
Activists are claiming that providing healthcare to transgender youth is a major medical scandal. The real scandal is that some journalists may be buying it.
Opinion, by Evan Urquhart
If you’re not careful about the sources of your information, you might wind up thinking that transgender healthcare, particularly the treatments for transgender youth, has become some sort of major medical scandal.
The phrase “medical scandal” has been cropping up all over anti-trans op-eds and right wing news stories in reference to gender-affirming care. It’s been used in reference to the dud story of the WPATH files and now repeatedly in the discussion of the recently released Cass Report. The scandal is supposed to be that young people are being rushed into unnecessary, dangerous medical transitions. The problem? There’s literally no evidence of that ever having happened.
Read our coverage of the WPATH Files and our reporting on the contents of the Cass Report.
Here’s one example of medical scandal language misrepresenting what’s going on with gender-affirming care from Spiked:
Another example, from the Telegraph, where the author blames “transgender ideology” for the supposed scandal:
Unlike any other medical scandal in history, the “scandal” of providing puberty blockers or cross-sex hormones to transgender youth doesn’t feature any patients who’ve been harmed by the supposed scandal. To the contrary, the very patients who are supposedly the victims in the story have expressed dismay that all the scandal talk is threatening their access to treatments that improved their quality of life.
Anyone familiar with the history of journalism and medicine should know the contours of a medical scandal. Scandals happen when doctors or researchers ignore their ethical duties to patients and engage in behavior that harms them. One notorious medical scandal involved Black men with syphilis in Tuskegee, Alabama. In that scandal, a research study on syphilis began before good treatments were available, but after a very short time antibiotics became a standard, and very effective, treatment. Hundreds of study participants were not informed of this or offered treatment and instead watched by researchers as the disease destroyed their bodies. Most died as the result of these unethical research practices, and the larger Black American community was harmed irreparably by a severe and long-lasting loss of trust in the medical establishment.
Another well known scandal involved a fertility doctor who lied to his patients while inseminating them, secretly using his own sperm while claiming the sperm came from an anonymous donor. In that scandal, 11 of the people harmed spoke movingly at the doctor’s fraud trial about the betrayal and shock they felt at learning their children’s genetic father was their doctor. As you can see, the size of a scandal may be larger or smaller
In the story about transgender youth healthcare, you won’t find hundreds of patients harmed by some malpractice or unethical behavior involving puberty blockers or cross sex hormones. In fact, it’s unclear if there’s one single family, in the whole world, where both the child and the parents agree there’s been some harm done from a minor transitioning.
The Cass Report? It doesn’t include any accounts of children harmed by puberty blockers or cross sex hormones. Although Cass reports having spoken with two detransitioners, there’s nothing in the Report indicating that they or any other patient was found to have been harmed by a premature or rushed transition.
All reports of patient harm in this story have fizzled. For example, a proposed UK lawsuit once claimed that they’d enlist a thousand families to sue the Tavistock youth clinic. However, zero families have thus far materialized, with the law firm admitting the response was “underwhelming” (and blaming cancel culture).
It should be self-evident that a “medical scandal” that can provide no evidence of patients being harmed is not a scandal, unless the scandal is the threat represented by false claims of scandal. However, in the story about gender-affirming care in the UK there is at least one group of patients who have said clearly and repeatedly that they’ve been harmed by NHS practices. Those are the patients on the multi-year waiting lists for care, who report their lives are on hold, their painful gender dysphoria raging untreated. Trans patients have sued over this issue, asking courts to step in and force the NHS to provide treatment in a timely manner.
The lengthening waiting lists for transgender healthcare, which impact youth as well as adults, have all the hallmarks of a medical scandal story, with patients speaking out about the harms of an unethical system that is biased against provision of treatment to a minority. The story about puberty blockers and cross sex hormones for minors, in contrast, looks nothing like this. That the media is treating the latter as a scandal is the real scandal.
Evan Urquhart is the founder of Assigned Media and an incoming member of the 2024-2025 Knight Science Journalism fellowship class at MIT.