AMAC Exclusive – By Katie Sullivan
As the Biden administration and the American left continue to push radical gender ideology on young children, many European countries – which American liberals have often looked to for inspiration – are pulling back on so-called “gender-affirming care” for minors.
The term “gender-affirming care” refers to a range of therapies, drug regimens, and surgeries aimed at aligning someone’s physical body with their self-professed gender identity. The dramatic increase in the prescription of cross-sex hormones and transgender surgeries for both minor girls and boys in recent years, all under the guise of “gender-affirming care,” has sparked significant controversy throughout the United States and Europe.
After several years in which these hormone treatments and surgeries were widely available for minors, many Western European countries are beginning to reverse course.
Last month, for instance, England limited the use of puberty blockers for minors to clinical trials. In February, Sweden, which was the first country to introduce legal gender reassignment, began restricting gender reassignment hormone treatments for minors. Finland has also reversed course on hormone treatments and transgender surgeries for anyone under 18.
Some European countries are also backtracking on teaching gender ideology in classrooms and providing gender-affirming therapy at school without parental consent. A new policy in the U.K. would prohibit schools from letting students identify by a gender that is different from their biological sex, including changing their preferred pronouns, without parental consent. The move comes after a number of secondary schools in the country were exposed for not informing parents when their children questioned their gender identity.
In addition to obtaining parental consent prior to entertaining gender fluidity in students, school leaders and teachers will also be required to consider the effects a gender transition would have on students’ mental health.
U.K. Prime Minister Rishi Sunak said of the changes, “These are really sensitive areas, it’s important that we treat them sensitively and that parents know what’s going on.” Sunak also told The U.S. Sun, “We have to recognize that any degree of social transition could have potentially quite a significant impact and consequences for a child.”
However, while Europe is beginning to recognize the potential pitfalls of gender-affirming care for minors and the importance of keeping parents involved, the Biden administration and Democrats in the United States are moving in the opposite direction.
In March, Biden Assistant Secretary of Health Rachel Levine – who is transgender – announced that gender-affirming care for minors is supported “at the highest levels” of the administration. HHS has also released a brochure encouraging gender-affirming care for children and adolescents. Biden himself said, “Affirming a transgender child’s identity is one of the best things a parent, teacher, or doctor can do.”
Biden’s Department of Justice also issued a letter to state attorneys general in March 2022 threatening to weaponize anti-discrimination litigation tools against any states that prohibit transgender surgeries for minors. And last June, the president took significant flak for threatening to withhold funding for school lunch programs from districts that refused to embrace the administration’s views on gender ideology and gender-affirming care for minors.
Despite these moves, however, public opposition to hormone therapies and transgender surgeries for minors is growing at a rapid clip. According to one recent survey, 68 percent of U.S. adults say they oppose puberty-blocking medication for children aged 10-14, while 58 percent say they oppose hormone treatments for teens aged 15-17. Even when such practices are favorably framed as “gender-affirming care,” 43 percent of Americans now say they support legislation criminalizing gender-affirming care for minors, as opposed to just 28 percent who said the same in 2021.
The debate in the U.S. is now moving to the court system, where a growing slate of litigation is drawing clear battle lines.
In one recent case, Chief Judge Scott Skavdahl of the U.S. District Court of Wyoming blocked a school district from enforcing a policy that would allow school staff to withhold critical information about a student’s gender identity from their parents. While Skavdahl did not prohibit the district from calling students by their preferred name and pronouns, he affirmed the right of parents to be involved in such decisions.
However, in other cases liberal judges have blocked state laws prohibiting hormone therapies and transgender surgeries for minors. In Arkansas last month, U.S. District Court Judge James Moody, a Barack Obama appointee, struck down and permanently enjoined Arkansas Act 626, which banned “a physician or other healthcare professional from providing ‘gender transition procedures’ to any individual under eighteen years of age and from referring any individual under eighteen years of age to any healthcare professional for ‘gender transition procedures.’”
Alarmingly, Judge Moody found expert witnesses tapped by the state of Arkansas to defend the law to be not credible, but embraced the testimony of “experts” from the left-wing World Professional Association for Transgender Health (WPATH).
WPATH has drawn significant blowback in recent years for its increasingly radical “standards of care,” which are used by thousands of hospitals throughout the U.S. and Europe as a guidebook for what sort of drugs and procedures to prescribe to transgender-identifying youth. An early draft of the most recent edition of these standards recommended cross-sex hormones for teens as young as 14, double mastectomies for girls as young as 15, and full hysterectomies at 17. WPATH quickly amended the guidelines to remove the age minimums following serious public outcry.
An in-depth investigative report from Canada also found that “WPATH is not the typical professional organization that develops clinical practice guidelines.” Rather, “WPATH is a hybrid professional and activist organization, where activists have become voting members and have served as president.”
Taking the side of WPATH’s “experts,” Judge Moody ruled that Arkansas’s Act 626 failed under due process because it infringed upon parents’ fundamental right to seek medical care for their children, violated the Equal Protection Clause, discriminated against transgender people on the basis of sex, and violated the First Amendment rights of a doctor who, under the law, could not refer patients for gender-affirming care elsewhere.
Nowhere in Judge Moody’s ruling did he consider the legitimate health risks associated with medically unnecessary “gender-affirming care” for minors. As many have pointed out, while respecting parental rights and discretion is indeed important, those rights do not extend to activities that could bring significant harm to children, such as allowing them to consume drugs or alcohol.
That logic was at play in another court case in Kentucky, where Republican Attorney General Daniel Cameron – who is also the GOP nominee to unseat Democrat Governor Andy Beshear this fall – has challenged U.S. District Court Judge David Hale’s injunction blocking a new state law banning gender transition surgeries for minors. In his motion to lift the injunction, Cameron argued that parents have a “fundamental right to make decisions concerning the medical care of their children,” but it is only a “general right to make decisions among legally available medical treatments.”
The country is likely to see many more cases like these in the years ahead, as mounting medical evidence pointing to the dangers of gender-affirming care for minors clashes with the far-left’s ideological agenda. But with even Europe now backing away from certain treatments for kids, liberal politicians in the U.S. may soon face a reckoning at the ballot box if they refuse to back down.
Katharine “Katie” Sullivan was as an Acting Assistant Attorney General and a senior advisor to the White House Domestic Policy Council under President Trump. She previously served 11 years as a state trial court judge in Colorado.