Supreme Court Hearing on Transgender Youth Raises Critical Questions for Parents

The U.S. Supreme Court appears poised, after the hearing in United States v. Skrmetti last week, to uphold Tennessee’s ban on medical care designed to change a minor’s gender. Based upon questions asked at the hearing, the ruling will likely be based, at least in part, on the fact that European countries have enacted similar bans after studies showed the harm of such treatments outweighs the benefits.  

But such bans exist in only about half of U.S. states. Thus, the ruling will have no effect on such treatments in states like California and New York.  In fact, most of those states go the other way, banning any treatment designed to reduce gender dysphoria to make the child comfortable with their biological sex!  The constitutionality of those bans, which prohibit parents from seeking such counselling for their children, has been challenged and may ultimately also be decided by the Supreme Court. 

All of these cases beg the question still facing parents: What to do if your child tells you repeatedly he wants to be a girl? Should you seek counseling? Should you do nothing and hope that it passes? Or should you give him a girl’s name, let him wear a dress, and, in states which still permit it, take him for hormone treatment or surgery?

The activists would like you to believe that your child’s gender dysphoria should be embraced, and thus the proper treatment is assisting the child in their transition to the opposite sex as early as possible. They call this “gender affirming” care, even though it is actually “gender changing” care.  They denounce any care that may help a person identify with their biological sex.  

These activists have taken over the American Academy of Pediatricians (“AAP”) and the American Psychology Association (“APA”).  As a result, these associations have adopted a policy of helping children transition to the opposite sex at the earliest age possible.  It is all part of a movement to reduce the stigma associated with transgender by acting as if it is natural and normal.

In a policy statement issued by the AAP, the very first conclusion that they draw is that “discrimination based on gender, gender identity, or expression real or perceived is damaging to the socio-emotional health of children.” And their first recommendation is that youth who identify as transgender have access to “comprehensive gender affirming” care.  

Thus, their primary focus is on discrimination, and their primary recommendation is transitioning children as early as possible. They criticize not just providing psychotherapy, but even taking a wait and see approach.  They state, “This outdated approach does not serve the child because critical support is withheld. Watchful waiting is based on binary notions of gender in which gender diversity and fluidity is pathologized.”  In other words, the sooner you take your child at their word that they are the wrong sex the better.

This flies in the face of the recent research out of Europe. As Justice Alito noted at the hearing, the Swedish National Board of Health and Welfare concluded that “the risks of puberty blockers and gender-affirming treatments are likely to outweigh the expected benefits of these treatments.”

It is not natural or normal to feel that you are in the wrong body. That is why it was labeled “gender identity disorder” for so many years, until it was changed to gender dysphoria.  It was changed to reduce the stigma. Reducing the stigma is great, but not it does not change the science. It is, by definition, a disorder, as it is a disruption of normal physical or mental functions.

Why not treat a disorder by trying to minimize or eliminate the disorder? We do that with every other disorder: bipolar, schizophrenia, depression, anxiety, obsessive compulsive, substance abuse, ADD, body dysmorphia, bulimia, borderline personality (In fact, most people with gender dysphoria also have one of these disorders). But when it comes to gender identity disorder, the activists insist it be embraced rather than treated.  The foundation for their argument is that children are “born this way.”

Yet, we know this is not true based upon identical twin studies which reveal that the majority of time, when one twin is LGBT, the other is not. Same DNA, different outcome.  Scientists have now mapped the entire human genome.  No transgender gene has been found.  Even those who believe it is a combination of nature and nurture recognize that environmental factors play a key role. The most likely explanation is that the disorder stems from early childhood trauma, just like so many other conditions which manifest later in life.  

This is critical for parents to know. If a child is born transgender, then the loving thing to do is embrace it as early as possible. Many parents are doing just this because the “born this way” mantra has been beat into their heads by the activists. However, since we know this is not the case, the best thing to do for a child experiencing gender dysphoria is to try to reduce the dysphoria. This can be done the same way as other disorders, through traditional psychological counseling. 

The most effective counseling usually involves examining a patient’s childhood and looking for childhood traumas. The most common form of childhood trauma involves poor, abusive, or absent parenting, but it can also come from abuse by family members or friends. Treatment for a boy may involve ensuring bonding with a male role model and ensuring he is not being bullied by others in a way that causes him to retreat from his maleness.   

However, because the activists are so focused on reducing stigma by insisting that trans is a natural and normal, they maintain that such counseling is inherently wrong, and seek to ban it. But merely because something can or should be treated with psychotherapy does not mean that we should stigmatize or look down upon those who need the treatment. Can you imagine not providing alcoholics with treatments simply so that society does not stigmatize the alcoholics? They are putting the feelings of the group over the individual needing treatment. 

Incredibly, 25 states have made psychotherapy to reduce dysphoria in children under 18 illegal. They disparagingly refer to the therapy as “conversion therapy,” calling it shaming or “praying away the gay,” but the therapy has been proven successful by the Alliance for Therapeutic Choice and Scientific Integrity and by the, now shuttered, Centre for Addiction and Mental Health’s Child, Youth, and Family Gender identity Clinic in Toronto. And if it does not work, the patient is still free to transition to the opposite sex.  It does not work so well the other way. Yet these states ban counselling while permitting surgery!  The bans have been challenged in court, which could also ultimately be heard by the Supreme Court. 

There should be love, acceptance, and non-discrimination for all adults and children with gender dysphoria, but the price for this cannot be the denial of science. We should have both acceptance and recognition that this childhood disorder can and should be treated without hormone treatments and surgery.