When gender critics and gender advocates spar, the more thoughtful opponents at some point usually attack and parry with links to published research. There is sparse conclusive evidence regarding transsexual or transgender adults, but at least you can link to what little there is when making your points.
When it comes to systematic studies of the growing number of children and adolescents undergoing medical “transition” via hormones and surgeries? Not so much. In fact, pretty much nothing. Zilch. Nada.
As I discussed in this post, pediatric gender specialists—endocrinologists, pediatricians, psychiatrists— openly acknowledge that there is essentially no research about the effects and outcomes of childhood medical transition.
So what generally happens when more data is needed about an accelerating and urgent medical problem, one for which experimental treatments are being prescribed? Teams of doctors and/or academic researchers write grants to fund rigorous studies. In the US, important medical research is often funded through the National Institutes of Health or other government-funded agencies. Given the increase in gender dysphoric kids popping up for treatment*, it seems likely the NIH would be quite amenable to funding well-designed studies. Particularly since the medical treatments for childhood gender dysphoria are so extreme that they can result in the permanent sterilization of minors.
There are plenty of potential research subjects being seen in gender clinics right now. While the practice is relatively new, hormone treatment for gender dysphoric kids has been ongoing in the US since 2007 (first cases at Boston’s Children’s hospital) and for over 20 years in the Netherlands. There has been ample time for researchers to apply for and receive funding.
What could be studied in these children who are having natural puberty arrested? I can think of a few interesting lines of research:
- The physiological and psychological effects of GnRH agonists (“puberty blockers”) on gender dysphoric children and adolescents
- The physiological and psychological effects on adolescents who have gone directly from GnRH agonists to cross-sex hormones
- Brain activity and neurological effects on adolescents who have delayed puberty; such studies could include noninvasive MRI and fMRI brain scans, coupled with behavioral observations
- Attitudes and opinions of gender dysphoric children and adolescents vis-à-vis permanent loss of fertility and how these attitudes and opinions change (or don’t change) over time
- Executive function development in prepubescent children who are under treatment vs. a control group of children who are not treated
- Long term outcome studies comparing gender dysphoric children who undergo hormone and surgical treatments vs. those who do not
There are many other avenues research could take. And these studies, to be meaningful, ought to be longitudinal (over the longest time span possible), and start as soon as possible after the child begins treatment.
So given the desperate need for research being called for by all the experts in the field, surely some studies have been funded and are actively recruiting subjects?
The place to find current research studies is ClinicalTrials.gov. (The database also lists recently closed studies that are no longer recruiting). ClinicalTrials.gov indexes all studies in the world—not just the US—which are seeking subjects.
Here’s a sample of what I found—more to the point, what I didn’t find. I tried many permutations of keyword searches and came up essentially empty. I encourage readers to do their own searches and tell us your results in the comments section.
- Puberty blocker: 0
- GnRH agonist: Hundreds—but all for either cancer patients or for precocious puberty
- GnRH agonist gender dysphoria: 0
- GnRH agonist child gender: 0
- GnRH agonist fertility: 99, all about adult cancer patients
- MRI gender dysphoria: 0
- Child (or adolescent) transgender: 4, all about HIV prevention
- Gender dysphoria: 3, all about HIV risk
- Adolescent transgender: 2, both about HIV prevention
- Leuprolide [generic name for Lupron, a puberty blocker]: Hundreds—but all for either cancer patients or for precocious puberty
- Leuprolide transgender: 0
When it comes to medicine, if there are no current studies recruiting new subjects, it typically indicates that the research questions have been more or less settled. A clinical problem or hypothesis has been thoroughly explored, studies have been conducted, the results have been replicated, and evidence-based clinical practice follows from there.
But the use of off-label GnRH agonists followed by cross-sex hormones on prepubescent children is new. We don’t have the data. And unless someone collects that data in a systematic way, we will never know the outcome of this grand experiment on young people.
What we have now are anecdotes, personal testimonies, and shrill voices demanding medical transition for children NOW. The usual reason given is suicide prevention. But if innate gender is real, this means there have been “transgender” children and adolescents since the dawn of human history. Yet there is no prior record of nor claim of suicidal children claiming to be “in the wrong body” before the modern age, when pharmaceutical and surgical solutions have become de rigeur.
Surely we can all agree that any treatment meant to prevent suicide; any treatment resulting in possible sterilization of minors deserves serious and wide-ranging study. Someone needs to get moving.
But the evidence suggests—no one is.
As one detransitioned woman has said, “We aren’t even lab rats.”
*A cursory Internet search reveals many stories about the steady increase in kids referred to gender clinics throughout the Western world