Gender Medicine Monthly
This is the 6th edition of my newsletter Gender Medicine Monthly, dedicated to sharing updates related to gender medicine with a particular focus on pediatric gender medicine and the affirmative model of care, for paying subscribers.
March’s inaugural issue is free, as well as a preview of the first part of this issue. If you find the content of this newsletter valuable, please consider becoming a paid subscriber. Your support helps me dedicate my time and energy to producing quality content.
Here are some headlines in gender medicine from the month of August (and the first week of September) covered in this edition of Gender Medicine Monthly.
Denmark joins growing list of countries to restrict pediatric medical transitions
Doctors and advocacy groups petition FDA to review off-label use of puberty blockers for pediatric medical transition
SEGM highlights bias in adult gender surgery study with limited youth relevance
The New York Times corroborates the St. Louis gender clinic whistleblower story
A recent study provides new insights on youth gender transition surgeries
Four celebrities spoke out against gender ideology or youth transition and faced media backlash
A new Australian documentary spotlights detransitioners
The detransition subreddit reaches 50,000 members
1. Denmark joins growing list of countries to restrict pediatric medical transitions
Source: SEGM 8/17/23
Denmark has made a quiet yet decisive shift in its approach to treating youth with gender dysphoria. Instead of primarily endorsing medical interventions like puberty blockers, hormones, or surgeries, the country is now emphasizing therapeutic counseling and psychological support.
The renowned Danish medical journal, Ugeskrift for Læger ("Weekly Journal for Physicians"), recently published an article highlighting a significant shift in Denmark's treatment of youth with gender dysphoria. Over the past decade, like many Western nations, Denmark witnessed a surge in young individuals identifying with gender dysphoria.
From just 4 pediatric cases requesting gender reassignment in 2014, the number soared to 352 by 2022, marking an 8700% increase.
In 2018, Denmark's centralized gender service had medically transitioned 65% of the referred youth, aligning with the high transition rates reported by pediatric gender clinics internationally.
By 2022, only 6% of the youth referred to the centralized gender clinic in Denmark were prescribed hormonal treatments, and surgical transitions for minors were completely discontinued.
The journal article elucidates this change by pointing to the inherent risks and uncertainties surrounding life-altering medical interventions for minors, especially in light of the limited understanding of the rapid epidemiological change, rising detransition rates, and the unknown long-term outcomes.
Significance: Denmark is the 4th country to implement stricter regulations on medical transitions for minors. Norway will soon follow.
Denmark joins Finland, Sweden, and England to align their guidelines with systematic reviews of evidence (the gold standard of evidence-based medicine) and restrict youth medical transition, emphasizing psychotherapy as a frontline response.
Public health authorities in other countries like France, Ireland, Italy, Australia, and New Zealand have begun raising concerns or reevaluating their stances.
The United States is quickly becoming a global outlier for their reluctance to align their guidelines with the best available evidence.
2. Doctors and advocacy groups petition FDA to review off-label use of puberty blockers for pediatric medical transition
Source: Regulations.gov 9/5/23
Medical professionals, health experts, and advocacy groups have approached the Food and Drug Administration (FDA) with a petition, advocating for a halt on the off-label use of puberty blockers, such as Lupron Depot-PED and Supprelin LA, for medical transition purposes. These drugs, originally approved for conditions like certain cancers and early-onset puberty, have been used off-label for children who wish to medically transition.
The petitioners contend that using these drugs for medical transition exposes children to potential risks not covered by existing FDA guidelines, emphasizing that the off-label use lacks demonstrable benefits, which has led countries like Sweden, Finland, the UK, and Norway to reconsider such treatments for gender dysphoria.
The signatories conclude by urging the FDA to commission a thorough review by the National Academy of Sciences, Engineering, and Medicine (NASEM) and call for extensive studies on the off-label use. They also recommend the creation of an FDA website to specifically address this issue and to caution manufacturers and providers about the consequences of unlawfully promoting off-label use.
Significance: The FDA has yet to approve puberty blockers and sex hormones for pediatric gender care, and their current use in this context is off-label and experimental.
No clinical trials confirm the safety of these drugs for such unapproved uses, and drug manufacturers have consistently avoided conducting safety trials for this group.
After incidents of suicidal thoughts in children receiving puberty blockers were reported in 2016, the FDA mandated drug manufacturers to include a warning label about potential psychiatric issues. Last year, the FDA issued an additional warning about a severe potential side effect of puberty-blocking drugs. This side effect can lead to a dangerous increase in spinal fluid pressure in the brain, causing symptoms like headaches, nausea, double vision, or even permanent vision loss.
3. SEGM highlights bias in adult gender surgery study with limited youth relevance
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