For nearly a decade, the vanguard of the transgender-rights movement — doctors, activists, celebrities and transgender influencers  — has defined the boundaries of the new orthodoxy surrounding transgender medical care: What’s true, what’s false, which questions can and cannot be asked. 

But that new orthodoxy has gone too far, according to two of the most prominent providers in the field of transgender medicine: Dr. Marci Bowers, a world-renowned vaginoplasty specialist who operated on reality-television star Jazz Jennings; and Erica Anderson, a clinical psychologist at the University of California San Francisco’s Child and Adolescent Gender Clinic. 

In the course of their careers, both have seen thousands of patients. Both are board members of the World Professional Association for Transgender Health (WPATH), the organization that sets the standards worldwide for transgender medical care. And both are transgender women.

Earlier this month, Anderson told me she submitted a co-authored op-ed to The New York Times warning that many transgender healthcare providers were treating kids recklessly. The Times passed, explaining it was “outside our coverage priorities right now.”

Since nearly seven in 10 children initially diagnosed with gender dysphoria eventually outgrew it — many go on to be lesbian or gay adults — the conventional wisdom held that, with a little patience, most kids would come to accept their bodies. The underlying assumption was children didn’t always know best.

But in the last decade, watchful waiting has been supplanted by “affirmative care,” which assumes children do know what’s best. Affirmative care proponents urge doctors to corroborate their patients’ belief that they are trapped in the wrong body. The family is pressured to help the child transition to a new gender identity — sometimes having been told by doctors or activists that, if they don’t, their child may eventually commit suicide. From there, pressures build on parents to begin concrete medical steps to help children on their path to transitioning to the “right” body. That includes puberty blockers as a preliminary step. Typically, cross-sex hormones follow and then, if desired, gender surgery.

Anderson said that we’re likely to see more regret among this teenage-girl population. “It is my considered opinion that due to some of the — let’s see, how to say it? what word to choose? — due to some of the, I’ll call it just ‘sloppy,’ sloppy healthcare work, that we’re going to have more young adults who will regret having gone through this process. And that is going to earn me a lot of criticism from some colleagues, but given what I see — and I’m sorry, but it’s my actual experience as a psychologist treating gender variant youth — I’m worried that decisions will be made that will later be regretted by those making them.”

I asked Bowers about the rise of detransitioners, young women who have come to regret transitioning. Many said they were given a course of testosterone on their first visit to a clinic like Planned Parenthood. “ When you have a female-assigned person and she’s feeling dysphoric, or somebody decides that she’s dysphoric and says your eating disorders are not really eating disorders, this is actually gender dysphoria, and then they see you for one visit, and then they recommend testosterone — red flag!” Bowers said. “Wake up here.”

Full story at Substack.