A protester outside the German Bundestag. Inside, parliament is discussing a law that makes it easier to change name and gender in official documents. Image AP
The European Association for Child and Adolescent Psychiatry (Escap) warns against careless prescribing of puberty blockers and cross-sex hormones to young people. “We don’t want to push them in one direction.”
The European Association of Psychiatrists emphasizes the importance of prioritizing the well-being and safety of trans young people in their care. In a statement, Escap, which includes psychiatrist associations from 36 countries, calls on healthcare providers not to “promote experimental and unnecessarily invasive treatments with unproven psychosocial effects.”
The use of puberty blockers and cross-sex hormones in the Dutch protocol helps individuals achieve the desired physical characteristics of their identified gender.
According to the statement, ‘extreme caution’ is required when prescribing medication for young people with gender dysphoria. According to Escap, there is a significant shortage of scientific research into both the long-term consequences of medical treatment and the natural course of feelings of gender dysphoria without medical treatment.
Worries about increases
The direct reason for the psychiatrist’s statement is the increase in the number of young people registering for gender care, says Robert Vermeiren. He is one of two Dutch professors who collaborated on the piece. “Several professionals in Europe are concerned about this increase.” The increase is enormous among born girls.
“There is a change in the profile of the applicants,” says Vermeiren; raising the question of whether the existing protocol is sufficiently tailored to them.
In the Netherlands, the number of young people on the waiting list for gender care increased from 2820 to 8630 between 2019 and 2022. In England, a similar increase prompted a critical report by pediatrician Hilary Cass. The English health service decided only to prescribe puberty blockers if the young person participates in a scientific study. The largest clinic for gender care, Tavistock, was also closed there due to careless actions.
“We see in many other countries that the strictness and neatness of the Dutch protocol is not applied,” says Vermeiren. There are particular concerns that puberty blockers are prescribed quickly, while they can act like a trap. Vermeiren: “They would be used to give young people time to determine whether they want to continue in their transition. However, in an analysis, we see that almost everyone continues with cross-sex hormones after puberty blockers. Is that correct?”
Research also shows that a diagnosis of gender dysphoria can be “unreliable and unstable” over time, the psychiatrists write in their statement. In other words, maybe those feelings will disappear or change.
“The problem is that we don’t have a crystal ball,” says Vermeiren. And even after medical treatment or the absence thereof, it isn’t easy to compare. “Someone who is unhappy without medical treatment might also have been unhappy in the other case.”
Polarization
Another concern of Escap is the polarization of the debate, says the psychiatrist. “If you are critical of this concern, it seems as if you belong to the anti-groups. If you go along with it as if you were only a pro, we hope for a good discussion and want people who really want to change their gender to have that opportunity. At the same time, we don’t want to push them in one direction.”
Also read:
Researchers Radboud University: Medical treatment is not necessary for everyone waiting for transgender care
In some cases, people on the waiting list for transgender care are better off going to regular mental health care or their GP, say researchers at Radboud University. People who have questions about gender or discrimination benefit more from this than from a medical process.
Share this content:
About The Author
