healthcare and medical concept , Close-up of surgeons hands holding surgical scissors and passing surgical equipment , motion blur background.
healthcare and medical concept , Close-up of surgeons hands holding surgical scissors and passing surgical equipment , motion blur background.
Humanize From Discovery Institute's Center on Human Exceptionalism

HHS: Castrations/Mastectomies Okay for Transgender Minors

Originally published at National Review

President Biden’s HHS has gone all-in on radical transgender ideology, encouraging early body-changing medical interventions as “gender-affirming” care. From the HHS Office of Population Affairs publication:

Gender-affirming care is a supportive form of healthcare. It consists of an array of services that may include medical, surgical, mental health, and non-medical services for transgender and nonbinary people.

For transgender and nonbinary children and adolescents, early gender-affirming care is crucial to overall health and well-being as it allows the child or adolescent to focus on social transitions and can increase their confidence while navigating the healthcare system.

And it can ruin their lives, too.

What kind of interventions constitute “early gender-affirming care”?

  • Social Affirmation: Adopting gender-affirming hairstyles, clothing, name, gender pronouns, and restrooms and other facilities
    When: At any age or stage. Reversible
  • Puberty Blockers: Using certain types of hormones to pause pubertal development
    When: During puberty. Reversible.
  • Hormone Therapy: Testosterone hormones for those who were assigned female at birth Estrogen hormones for those who were assigned male at birth
    When: Early adolescence onward. Partially reversible
  • Gender-Affirming Surgeries:
    “Top” surgery – to create male-typical chest shape or enhance breasts
    “Bottom” surgery – surgery on genitals or reproductive organs
    Facial feminization or other procedures
    When: Typically used in adulthood or case-by-case in adolescence. Not reversible.

This is awful. Children and adolescents with gender dysphoria certainly need proper care and support. But puberty blocking is not benign and can lead to adverse medical issues such as reduced bone density — which is why it is no longer recommended in the U.K. and Finland, for example.

Mutilating surgeries on genitals and breasts of minors should be off the table altogether. They are irreversible, result in sterilization when of the genitals, and remove healthy organs.

At the very least the government should acknowledge that these drastic interventions are controversial, remain experimental — puberty blockers are “off label” uses of medicines approved to treat pathologies in adolescence — and indeed, sometimes leave patients permanently harmed. This is particularly true in cases where they “detransition” — that is, regain acceptance that they are, indeed, the sex they were born.

Expect the usual suspects to accuse those opposing this drastic recommendation as being motivated by hate as a means of stifling reasoned discourse. Indeed, President Unity has already called state laws to protect transgender minors from such interventions “hateful.”

The reality is exactly the opposite. Love requires that we defend the procreational futures of children and their bodily integrity, particularly in a time of raging moral panic when emotions rule the day. Adults can do what they please. But minors need protection, sometimes, even from themselves.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.