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Media Misrepresents New Dutch Study on Minor Transition

On October 20, the medical journal The Lancet published a paper showing that 98 percent of “people who had started gender-affirming medical treatment in adolescence continued to use gender-affirming hormones at follow-up.” In the “Interpretation” section of the paper’s Summary, the authors say that “The continuation of treatment is reassuring considering the worries that people who started treatment in adolescence might discontinue gender-affirming treatment.” This has led many US media outlets, including NPR, to celebrate this high conversion rate as incontrovertible truth that puberty blockers are an effective form of “gender affirming care.”

Laura Wamsley, writing for NPR said that the findings are significant “because of ongoing political debates over whether young people should receive gender-affirming treatment.” She further says that the paper’s findings run counter to narratives that young people seeking to medically transition “are simply going through ‘a phase’ that they'll grow out of.”

There are several things very wrong with this portrayal of the new study. The first and most glaring error is to compare the children in this Dutch study with the children comprising the new surge in the United States seeking to medical transition. The cohort of children assessed in the Lancet paper were selected according to very stringent inclusion criteria, such as requiring that children have supportive families, no serious comorbid mental health issues, and no history of social transition. In contrast, the children being referred to gender clinics in the United States have often show up already socially transitioned and then receive very limited assessments before being prescribed puberty blockers. There is very good reason to believe that social transition alone is an intervention that makes desistance much less likely.