US worst country for pushing 'extreme gender ideology,' sex change surgeries on youth: report

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The United States is the most permissive country when it comes to pushing gender ideology and prescribing puberty blockers and cross-sex hormones to children, compared to nearly a dozen European countries that have implemented more strenuous barriers for youth seeking to obtain drugs and body-mutilating surgeries to look more like the opposite sex. 

Do No Harm, which describes itself as “a diverse group of physicians, healthcare professionals, medical students, patients, and policymakers” determined to “protect healthcare from a radical, divisive, and discriminatory ideology,” released research titled “Reassigned” Monday that explained, “extreme gender ideology drives the United States to provide transgender medical care to younger children, while Europe goes a safer and more scientific route.”

The report concluded that while the U.S. continues to defer to “gender-affirming care,” which views the refusal to “affirm” a trans-identified youth’s self-professed sexual identity as “harmful and unethical,” European countries have begun to follow a different approach. The report attributes the embrace of so-called gender-affirming care in the U.S. to the fact that “the belief that biological sex and gender are socially constructed has made its way into American classrooms, courtrooms, bathrooms, and boardrooms.”

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The research compared the policies of the U.S. with those of 11 western and northern European countries. The U.S. differs from most other countries because of its 50 states, which each have different policies. However, the policies of some states make the U.S. the most lenient among the nations studied.

For example, the research found that while “some states restrict minors’ access to sex reassignment surgery,” double mastectomies have been “performed on [girls] as young as 12.”

Sex reassignment surgeries include the removal of both testicles (orchiectomy), chopping off a penis (penectomy) in an attempt to create a vagina (vaginoplasty) — a procedure that leads to frequent infections — or the removal of tissue from a patient's arms or legs to create a fake penis (phalloplasty) that doesn't look natural, is flaccid and cannot function. 

By contrast, more than half of the European countries examined in the research have set the minimum age for sex change surgeries at 18: Belgium, Denmark, Finland, Luxembourg, Sweden and the United Kingdom. Iceland and Ireland have a minimum age of 16 for sex change surgeries. While Norway and the Netherlands permit trans-identified girls to have double mastectomies at 16, all other procedures are only available to adults. 

The research states that in France, gender reassignment surgery is “theoretically possible from age 14, but researchers say that, to their knowledge, torsoplasties (the removal of back fat) are the only surgeries that have been performed on trans youth.” In all other cases, patients seeking sex change procedures must be at least 18. 

The U.S. also has much looser age restrictions for prescribing cross-sex hormones than the European countries. As the report explains, cross-sex hormones are “administered to alter a person’s secondary sex characteristics to better align with their gender identity.”

The research identifies Oregon as the state with the lowest minimum age requirement for obtaining cross-sex hormones, which stands at 15. While France does not have official age restrictions on cross-sex hormones, anyone younger than 18 seeking such treatment must secure parental consent. Luxembourg also lacks guidance on the prescription of cross-sex hormones, as most people seeking them do so out of the country.

In all other European countries, trans-identified youth must be at least 16 to gain access to cross-sex hormones. In Belgium, Denmark, Iceland, Ireland, Norway, the Netherlands and the United Kingdom, 16-year-olds can obtain cross-sex hormones with or without parental consent. Finland enables 16-year-olds to access cross-sex hormones as long as they receive parental consent. 

Most European countries studied have stricter requirements for prescribing puberty blockers than the U.S., where children as young as 8 have been able to take them. As stated in the report, puberty blockers “suppress the release of sex hormones so that gender-questioning youth do not sexually develop in a way that diverges from their gender identity.”

Most U.S. states require minors to secure parental consent before taking puberty blockers. In terms of the laws on the books, Oregon is once again the most permissive state, allowing 15-year-olds to obtain puberty blockers.

In Denmark, Sweden and the Netherlands, a 12-year-old can take puberty blockers as long as they receive parental consent. Finland makes puberty blockers available to trans-identified youth as young as “about age 13” with parental consent, while Ireland and the United Kingdom do not have a minimum age for a child to obtain puberty blockers. However, Ireland requires those younger than 16 to receive parental consent before they can take puberty blockers.

Iceland does not have a minimum age for obtaining puberty blockers as long as parental consent is provided. France allows “minors at any age” to receive puberty blockers, while Norway allows medical professionals to provide puberty blockers “once physiological signs of puberty manifest.”

The U.S. has a significantly higher number of pediatric gender clinics that offer body-disfiguring surgeries and cross-sex hormones to trans-identified youth than its European counterparts. The U.S. has 60 pediatric gender clinics and 300 such clinics that provide puberty blockers and cross-sex hormones.

Sweden has four hospitals that provide “assessment and treatment” for trans-identified youth, while three of the hospitals perform sex reassignment surgery. Denmark has three locations that provide hormone therapy to youth suffering from gender dysphoria. Belgium and Finland have two facilities that specialize in treating youth with gender dysphoria. In contrast, Iceland, Ireland, the Netherlands and Norway each have one hospital that offers experimental procedures to most or all trans-identified youth. 

France enables “any doctor” to prescribe puberty blockers and cross-sex hormones for gender dysphoria. The U.K.'s controversial Tavistock clinic that pushed gender ideology on youth whose bodies are now deformed is set to be closed after an investigation and class action lawsuit. Following the expected shuttering of Tavistock, two clinics will assess and treat youth with gender dysphoria. While Luxembourg has one gender clinic, the research stresses that “treatment is more commonly sought abroad.”

The report notes that a handful of countries have changed their guidance about surgical interventions to address gender dysphoria in light of concerns about the long-term effects of such procedures, including infertility and disfigurement. Finland has issued guidelines recommending “psychotherapy, rather than puberty blockers and cross-sex hormones” as the first line of treatment for trans-identified youth following an evidence review yielding “inconclusive” results about the effectiveness of gender transition treatments.

Just last month, the Swedish National Board of Health and Welfare “published updated guidance that urges greater caution in administering hormonal treatments or sex reassignment surgeries to minors,” advising the limitation of such treatments to “exceptional” cases. France’s National Academy of Medicine has urged “great caution in treatment” for trans-identified youth, noting the “health risks and permanent effects” of hormonal and surgical interventions.

The U.S. also has much looser barriers to obtaining sex change surgeries, puberty blockers and cross-sex hormones, with these experimental procedures being deemed “well within the scope of a range of medical providers,” including physician assistants and medical professionals extending beyond psychiatrists and psychologists having the ability to diagnose gender dysphoria. 

On the other hand, Belgium requires children to obtain a letter from a psychiatrist, psychologist or sexologist before they can obtain “gender-affirming care.”

In Denmark, Sweden and the U.K., interdisciplinary teams featuring medical professionals of various backgrounds must diagnose youth as actually having gender dysphoria before they can have these life-altering procedures that could potentially render them sterile. 

Iceland requires a six-month observation period before youth can be given puberty blockers or cross-sex hormones. Youth in Ireland and Norway must live as the opposite sex for a specific period of time beforehand. Luxembourg and the Netherlands mandate that medical professionals consider the possibility that an underlying psychiatric condition causes gender dysphoria before prescribing drugs. Although France has looser requirements for dispensing cross-sex hormones, approval from an interdisciplinary team is necessary for youth to obtain surgery. 

The Do No Harm report comes after the American College of Pediatricians compiled a list of side effects of puberty blockers and cross-sex hormones. The long-term effects of puberty blockers include “osteoporosis, mood disorders, seizures, cognitive impairment and, when combined with cross-sex hormones, sterility.”

The American College of Pediatricians has warned that cross-sex hormones can cause an “increased risk of heart attacks, stroke, diabetes, blood clots and cancers.” Concerns about the long-term effects of surgical transitions for minors have prompted Alabama, Arizona and Arkansas to enact bills banning such procedures.

The Florida Boards of Medicine and Osteopathic Medicine have banned gender transition procedures for minors, while the Texas Department of Family and Protective Services and Texas Attorney General Ken Paxton have issued opinions classifying them as a form of child abuse. On the other hand, Massachusetts has declared “gender-affirming care” a constitutional right. 

Ryan Foley is a reporter for The Christian Post. He can be reached at:

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