The Body Wasn’t The Problem: Changing Children Physically Won’t Heal Them

For years, one of the most powerful arguments for medically transitioning children has been that these treatments are necessary for their mental health. Puberty blockers and hormones, Americans were told, could relieve the intense psychological suffering experienced by young people struggling with their gender. Critics who urged caution were frequently confronted with an emotionally devastating question: Would you rather have a transgender child or a dead child?

But a newly released report from a major taxpayer-funded study is raising an uncomfortable question: What if changing the child’s body doesn’t actually solve what is happening inside the child’s mind?

The National Institutes of Health funded a long-running research project titled “The Impact of Early Medical Treatment in Transgender Youth.” According to NIH records, researchers recruited 95 young people beginning puberty suppression and hundreds more beginning cross-sex hormone treatment.

The recently obtained final report on the blocker cohort found that after two years, mental-health measures remained relatively unchanged and were described as being within a “clinically non-significant range.” This hardly supports the simplistic claim that puberty blockers are a proven mental-health rescue.

That matters because these were deeply troubled young people before medical intervention began. According to the report, roughly half had clinically concerning depression and anxiety scores at baseline, about two-thirds had experienced suicidal thoughts, and approximately one-quarter reported having attempted suicide.

Those numbers should provoke compassion, but they should also provoke a different question: Why are these children suffering so profoundly in the first place? Instead of beginning with the assumption that the body needs to change, perhaps medicine should begin by exhaustively investigating what is happening within the child.

That is increasingly the direction other countries are taking. Britain’s landmark Cass Review concluded that the evidence supporting medical interventions for gender-distressed children was remarkably weak. NHS England subsequently ended the routine use of puberty blockers for gender dysphoria in minors, emphasizing holistic assessment, including mental-health and neurodevelopmental evaluation.

That approach recognizes something our culture seems increasingly reluctant to acknowledge: psychological distress can be real without every conclusion a distressed person reaches about himself or herself necessarily being correct. We understand this principle elsewhere in medicine. A person suffering from anorexia may sincerely believe his or her body is overweight, yet compassion requires taking that suffering seriously without requiring a doctor to agree with the patient’s perception of the body.

With gender distress, however, medicine has increasingly been asked to adopt a radically different principle: alter the body to accommodate the psychological perception. That should at least make us stop and ask whether we have reversed the proper direction of treatment.

The contradiction becomes even more striking when children are involved. We don’t allow a 12-year-old to buy cigarettes, a 14-year-old to drink alcohol, or minors to enter most legal contracts, gamble in casinos, or make countless other consequential decisions reserved for adults.

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