A Teen Gender-Care Debate Is Spreading Across Europe (2023)


Doubts have now come to the Netherlands, where the most-contested interventions for children and adolescents were developed.

By Frieda Klotz
(Video) Heated debate on gender pronouns and free speech in Toronto

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As Republicans across the U.S. intensify their efforts to legislate against transgender rights, they are finding aid and comfort in an unlikely place: Western Europe, where governments and medical authorities in at least five countries that once led the way on gender-affirming treatments for children and adolescents are now reversing course, arguing that the science undergirding these treatments is unproven, and their benefits unclear.

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The about-face by these countries concerns the so-called Dutch protocol, which has for at least a decade been viewed by many clinicians as the gold-standard approach to care for children and teenagers with gender dysphoria. Kids on the protocol are given medical and mental-health assessments; some go on to take medicines that block their natural puberty and, when they’re older, receive cross-sex hormones and eventually surgery. But in Finland, Sweden, France, Norway, and the U.K., scientists and public-health officials are warning that, for some young people, these interventions may do more harm than good.

European health authorities are not reversing themselves on broader issues of trans rights, particularly for adults. But this turn against the Dutch protocol has inflamed activists and politicians in the United States. Republicans who have worked to ban its recommended treatments claim that the shifts in Europe prove they’re right. Their opponents argue that any doubts at all about the protocol, raised in any country whatsoever, are simply out of step with settled science: They point to broad endorsements by the American Medical Association, the American Psychiatric Association, and the American Academy of Pediatrics, among other groups; and they assert that when it comes to the lifesaving nature of gender-affirming care, “doctors agree.”

But doctors do not agree, particularly in Europe, where no treatments have been banned but a genuine debate is unfurling in this field. In Finland, for example, new treatment guidelines put out in 2020 advised against the use of puberty-blocking drugs and other medical interventions as a first line of care for teens with adolescent-onset dysphoria. Sweden’s National Board of Health and Welfare followed suit in 2022, announcing that such treatments should be given only under exceptional circumstances or in a research context. Shortly after that, the National Academy of Medicine in France recommended la plus grande réserve in the use of puberty blockers. Just last month, a national investigatory board in Norway expressed concerns about the treatment. And the U.K.’s only national gender clinic for children, the Tavistock, has been ordered to close its doors after a government-commissioned report found, among other problems, that its Dutch-protocol-based approach to treatment lacked sufficient evidence.

These changes in Europe have so far been fairly localized: Health authorities in many countries on the continent—among them Austria, Denmark, Germany, Italy, and Spain—have neither subjected the Dutch approach to formal scrutiny nor advised against its use. Yet questions about the protocol seem to be spreading. At the end of March, for example, a Belgian TV report described a 42-fold increase in patients at a leading gender clinic in Ghent and raised questions about the right approach to care. Doubts about the protocol have even come to the country that invented it, at the Center of Expertise on Gender Dysphoria in Amsterdam. “Until I began noticing the developments in other EU countries and started reading the scientific literature myself, I too thought that the Dutch gender care was very careful and evidence-based,” Jilles Smids, a postdoctoral researcher in medical ethics at Erasmus University in the Netherlands, told me via email. “But now I don’t think that any more.”

Kirsten Visser, a Netherlands-based advocate and consultant for parents of trans teens, says her own son, Sietse, started receiving “definitely lifesaving” care at the Amsterdam center in 2012, at the age of 11. Around the time that Sietse showed up at the clinic, the Dutch protocol was becoming established internationally, largely through the work of a child and adolescent psychiatrist there named Annelou de Vries.

After completing a Ph.D. on gender dysphoria in Dutch adolescents, de Vries published two seminal papers with the clinical psychologist Peggy Cohen-Kettenis and other colleagues, in 2011 and 2014. The former looked at the psychological effects of puberty suppression on 70 young people over a period of two years, on average; the latter tracked outcomes for 55 of those people who had gone on to receive gender-reassignment surgery, over an average of six years. Taken together, the studies found that the teens showed fewer symptoms of depression after having their puberty suppressed, as well as a decrease in behavioral and emotional problems; and that the ones who went on to take gender-affirming hormones and have surgery grew into “well-functioning young adults.” De Vries’s expertise has since been widely recognized within the field: She served as a co-lead on the revision of the adolescent section of care guidelines recently published by the World Professional Association for Transgender Health, and is now president-elect of the European equivalent, EPATH.

But in the years after her two studies were released, research done in other European countries led to concerns about their relevance. In 2015, for example, Finnish researchers described a phenomenon that “called for clinical attention,” as they put it: More children were reporting gender dysphoria, and a greater proportion of them had been assigned female at birth. The fact that three-quarters of those Finnish teens had been diagnosed with separate and severe psychiatric conditions appeared to be at odds with the data from the Netherlands, the paper argued. The Dutch studies had found that just one-third of adolescents with gender dysphoria experienced other psychiatric issues, suggesting they were in far better mental health.

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In Sweden, too, clinicians grew alarmed by the sudden increase in the number of teenagers seeking gender care. Mikael Landén, a professor of psychiatry at the University of Gothenburg, told me that this population has increased 17-fold since 2010. One explanation for that change—that more open-minded attitudes around gender have emboldened kids to seek the help they need—just doesn’t ring true to him. He’d studied those views in his early work, he said, and found that, on the whole, Swedish attitudes toward transgender people have been very positive for a long time.

When the government asked Landén and a group of other scientists to write an evidence-based review of hormone-based treatments for young people, their verdict, after two years of study, was expressed definitively: The original research findings from de Vries were outdated, and do not necessarily apply to the group of teens who have been coming forward in more recent years. The Dutch protocol had been “a valuable contribution,” he told me, and “it was reasonable to start using it” in Sweden. But times had changed, and so had the research literature. In 2021, for instance, a team based at the U.K.’s Tavistock clinic published research showing no detectable improvements in the mental health of youngsters who had been put on puberty blockers and followed for up to three years.

Read: The war on trans kids is totally unconstitutional

De Vries acknowledged some concerns about the research when we spoke in February. “Our early outcomes studies were really from another time and comprised small samples,” she told me, and they looked only at trans youth who had experienced gender dysphoria from childhood. She granted that there is some research to suggest that kids who don’t arrive at the clinic until they’re older are worse off, psychologically, than their younger peers; but she also said her team has run studies including 16-year-olds, and that their findings were “not worrisome.” She agrees that other researchers have not replicated the long-term follow-up research on kids who went through the Dutch protocol, but she pointed out that the short-term benefits of such treatment have indeed been seen in other studies. Research conducted in the U.S., and published earlier this year, found that a group of 315 trans and nonbinary youth were on average less depressed and anxious, and better-functioning, after two years of hormonal treatment.

In the meantime, de Vries and her colleagues have urged clinicians in other countries to do more of their own investigation, in part because the youngsters who receive care at gender clinics in the Netherlands seem to be in comparatively good mental health from the get-go. It’s not yet clear, she told me, that studies of this group will be applicable to youth in other countries. “Every doctor or psychologist who is involved in transgender care should feel the obligation to do a good pre- and post-test,” one of de Vries’s co-authors on the 2011 and 2014 studies said to a Dutch newspaper in 2021. “The rest of the world is blindly adopting our research.”

De Vries is now working on a research project, funded by an $864,000 grant, that will try to answer newly forming doubts about the Dutch protocol. Her proposal for the grant, filed in 2021, described its subject as a “once so welcomed but now sharp[ly] criticized approach.”

That such criticisms are becoming mainstream even in her own country is itself a startling development. After all, the Netherlands has long been at the vanguard of progressive health-care practices. When the Dutch approach to transgender care for adults first started taking shape during the 1970s (many years before the protocol for kids would be established), the country’s politics were dominated by a steadfast opposition to taboos. James Kennedy, an American-born professor of modern Dutch history at Utrecht University, has described this as the country’s “compassionate culture”: In a radical departure from its traditional Christian conservatism, long-standing policies were being spurned; and even touchy subjects such as death and sex were made the subject of broad public-policy debates. Sex work, for example, was widely tolerated, then legalized in 2000. Similarly, the Royal Dutch Medical Association offered formal guidelines for the practice of euthanasia in the 1980s, and a corresponding national law—one of the world’s first—codified the rules in 2002.

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Against this backdrop of openness, in which doctors were seen as authoritative figures who were well equipped to decide what was best for their patients, one of the first dedicated clinics for transgender people was established in Amsterdam in 1972. It offered an array of services—blood tests, hormone therapy, and surgeries—to trans adults. According to a recent book by the historian Alex Bakker, Dutch surgeons, some of them inspired by their Christian beliefs, developed techniques that would reduce patients’ psychological suffering. “Helping those in need trumped ‘taboos’ about the sanctity of life or fixed gender roles,” Kennedy told me. The Dutch protocol for treating gender dysphoria in children, as established in the 1990s, reflected a further extension of this philosophy, aiming to smooth adult transitions by intervening early.

Read: Take detransitioners seriously

Nevertheless, in December, a journalist named Jan Kuitenbrouwer and a sociologist named Peter Vasterman published an opinion piece in a leading daily newspaper, NRC, that took aim at the Dutch protocol and its “shaky” scientific foundations, and alluded to the international scrutiny of the past few years. “It is remarkable that the media in our neighboring countries report extensively on this reconsideration,” the article said, “but the Dutch hardly ever do.” Like critics elsewhere, Kuitenbrouwer and Vasterman pointed to the rising numbers of children seeking care, from 60 to 1,600 in the Netherlands across a dozen years, and the unaccounted rise in those assigned female at birth; and they suggested that this new generation of people seeking treatment is not analogous to those included in the studies conducted by de Vries a decade ago. De Vries and some colleagues countered that their more recent research addresses this concern. “Scientific evaluation has always been an integral part of this challenging model of care, where young people make early decisions about medical interventions with lifelong implications,” they wrote in the same newspaper.

Also in December, a clinical psychologist at Radboud University’s gender clinic in Nijmegen named Chris Verhaak told a different Dutch outlet that puberty blockers affect children’s bones, and maybe also their brain development. “It is not nothing,” she said. Verhaak is currently running a government-funded study to understand the source and nature of the increase in the number of patients. (Results are due to be presented to the Dutch House of Representatives this year.) In another interview that month, she said that for up to half of cases, the gains in suppressing puberty are not clear. “I worry about that,” she told the newsweekly De Groene Amsterdammer. “Especially because we also experience enormous pressure to provide these puberty inhibitors as quickly as possible.”

Verhaak’s comments in particular sparked dismay among trans groups, which saw them as promoting destructive narratives about social contagion. Verhaak and her direct collaborators say that they are no longer speaking to the media until their study is released, but Hedi Claahsen, a professor and principal clinician on the Radboud center’s gender team, told me that practitioners are cautious and follow national guidelines. When I asked if her center’s approach differed from the one used in Amsterdam, she told me, “No clinic is exactly the same.” Individual providers, who are working at different institutions, may end up providing care that reflects “a different vision.”

Another, more significant round of criticism arrived at the end of February, when another widely read Dutch newspaper, de Volkskrant, published a 5,000-word article under a headline reading: “The treatment of transgender youth in the Netherlands was praised. Now the criticism of ‘the Dutch approach’ is growing.” The authors spoke with Iris, a 22-year-old woman who spent five years on testosterone and had a double mastectomy that she now regrets; they pointed to a new population of kids assigned female at birth seeking care only in their teens; and they noted reservations about the protocol in Finland and Sweden. “Is the ‘Dutch approach’ still the way to go?” the story asked.

The article prompted debate on Twitter, where Michiel Verkoulen, a health economist working with the government of the Netherlands to address the long-standing problem of ever-expanding waiting lists and their impact on young people’s mental health, accused the Dutch protocol’s critics of ignoring what he described as the elephant in the room. “What to do with the people for whom transgender care is critical?” he asked. “You can put every research aside, keep asking for more, and argue that diagnostics and treatments should be stricter … But the question remains: What then?”

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“In the Netherlands there are more and more people saying that gender diversity is woke and it’s nonsense and it’s bullshit,” Visser, the consultant for parents of trans teens, told me. Sam van den Berg, a spokesperson for an Utrecht-based trans-rights organization called Transvisie, argued that this debate does not need to happen. The quality of care for children with gender dysphoria is better in the Netherlands than almost anywhere else, she said. “We don’t feel it’s necessary to change anything.” Indeed, doctors in the Netherlands are still free to provide gender-affirming care as they see fit. The same is true of their colleagues in Finland, Sweden, France, Norway, and the U.K., where new official guidelines and recommendations are not binding. No legal prohibitions have been put in place in Europe, as they have been in more than a dozen U.S. states, where physicians risk losing their medical license or facing criminal sanctions for prescribing certain forms of gender-affirming care.

But the trend toward more conservative application of the Dutch protocol is likely to have real effects in European countries, in terms of which kids get treatment, and of what kind. Louise Frisén, an associate professor at Karolinska Institute and a pediatric psychiatrist at the child and adolescent mental-health clinic in Stockholm, Sweden, told me she worries that under her country’s new guidelines, many of her teenage patients will find it harder to access medical care. The benefits of treatment are clear, she said, and she further claimed that the policy change has caused anguish for some patients who are panicking at the looming prospect of puberty.

As for de Vries, when I spoke with her a few weeks before the article in de Volkskrant was published, she agreed that clinicians should be cautious, but not to the point where treatment becomes inaccessible. Outcomes for those with later-onset dysphoria do need to be investigated further, she acknowledged, but “if we are going to wait ’til the highest-standard medical evidence provides us the answers, we will have to stop altogether.” In that sense, Europe’s brewing disagreement over treatment could turn into paralysis. “That’s what worries me,” she said. “You will always have to work with uncertainties in this field.”


What is the regret rate for gender-affirming surgery? ›

In a review of 27 studies involving almost 8,000 teens and adults who had transgender surgeries, mostly in Europe, the U.S and Canada, 1% on average expressed regret. For some, regret was temporary, but a small number went on to have detransitioning or reversal surgeries, the 2021 review said.

How old do you have to be to start testosterone in Washington state? ›

Gender Affirming Hormone Therapy Services are available for patients 18 years and older at all of our eleven health centers in Eastern Washington.

How does gender-affirming care affect mental health? ›

Research demonstrates that gender-affirming care improves the mental health and overall well-being of gender diverse children and adolescents.

What is the best treatment for gender dysphoria? ›

Treatment for adults
  • psychological support, such as counselling.
  • cross-sex hormone therapy.
  • speech and language therapy (voice therapy) to help you sound more typical of your gender identity.

What are the problems with gender reassignment surgery? ›

The possible risks of transfeminine bottom surgery include, but are not limited to, bleeding, infection, poor healing of incisions, hematoma, nerve injury, stenosis of the vagina, inadequate depth of the vagina, injury to the urinary tract, abnormal connections between the urethra and the skin, painful intercourse and ...

Is gender reassignment surgery the same as gender-affirming surgery? ›

Gender affirming surgery, also known as sex reassignment surgery (SRS) or confirmation surgery, is the surgical procedure(s) by which a transgender or non-binary person's physical appearance and functional abilities are changed to align with the gender they know themselves to be.

Can I get top surgery at 14? ›

Though most individuals undergoing top surgery are 18 or older, younger individuals may be considered for the procedure if the patient, their legal guardians, and their mental health professional are in agreement that top surgery is appropriate.

Are puberty blockers FDA approved for gender dysphoria? ›

None of the puberty blocker medications are approved by the Food and Drug Administration to take for gender dysphoria (dis-FOR-ee-uh), but they are still very commonly used to treat it.

How long does it take to transition from female to male? ›

Depending on multiple factors, the transition process can take anywhere from months to years to complete. These include the age when a person recognizes that their true gender identity doesn't match their bodies, whether they choose to start medical treatment, and which treatments they choose.

What gender suffers from mental health the most? ›

Today, women are three times more likely than men to experience common mental health problems. In 1993, they were twice as likely. Rates of self-harm among young women have tripled since 1993. Women are more than three times as likely to experience eating disorders than men.

Does gender-affirming healthcare save lives? ›

In short, gender-affirming healthcare saves lives.

A safe and affirming healthcare environment is critical in fostering better outcomes for transgender, nonbinary, and other nonconforming individuals.

Do puberty blockers cause infertility? ›

Taking puberty blockers alone should not affect your ability to have a baby in the future. But if you also take estrogen or testosterone, this can affect it. If your body has ovaries that produce eggs, taking testosterone can affect the ability to produce them.

What is the root cause of gender dysphoria? ›

The exact cause of gender dysphoria is unclear. Gender development is complex and there are still things that are not known or fully understood. Gender dysphoria is not related to sexual orientation. People with gender dysphoria may identify as straight, gay, lesbian or bisexual.

At what age is gender dysphoria most common? ›

Gender dysphoria history: Of the 55 TM patients included in our study, 41 (75%) reported feeling GD for the first time by age 7, and 53 (96%) reported first experiencing GD by age 13 (Table 2).

Can gender dysphoria start after puberty? ›

Gender dysphoria might start in childhood and continue into adolescence and adulthood. Or you might have periods in which you no longer experience gender dysphoria. You might also experience gender dysphoria around the time of puberty or much later in life.

Why won t insurance cover gender reassignment surgery? ›

Federal and state law prohibits most public and private health plans from discriminating against you because you are transgender. This means, with few exceptions, that it is illegal discrimination for your health insurance plan to refuse to cover medically necessary transition-related care.

Does gender reassignment surgery hurt? ›

Some pain and discomfort is normal during recovery from gender reassignment surgery, but some patients have additional issues that impede the normal healing process and may cause pain to linger or even worsen over time.

Which gender reassignment surgery is better? ›

Male to female genital surgery is easier, less expensive and generally more successful than female to male surgery. That's one reason why fewer women choose to have surgery on their genitals, Bowers said. (Another is cost.)

Can I get a hysterectomy as a gender-affirming surgery? ›

Hysterectomy with and without salpingectomy/oophorectomy is considered by WPATH to be a medically necessary component of gender affirming surgical therapy for those transgender men who choose to seek this procedure.

What is transfem bottom surgery called? ›

MTF Bottom Surgery

Penile skin inversion vaginoplasty, with or without scrotal skin grafting. Revision vaginoplasty using small bowel or the rectosigmoid colon. Secondary genital reconstruction.

Can a female have gender reassignment surgery? ›

In female-to-male transsexuals, the operative procedures are usually performed in different stages: first the subcutaneous mastectomy which is often combined with a hysterectomy-ovarectomy (endoscopically assisted).

Can a 13 year old get breast implants? ›

There are no specific laws in the United States that prevent teenagers from getting cosmetic surgery; however, parental consent is required for patients under the age of 18.

How much is top surgery for a 16 year old? ›

Because teenagers in most states must be 18 before they can provide medical consent, surgeons require parental consent and approval letters from mental health care providers. The two- to four-hour procedure costs anywhere from $9,000 to $17,000, depending on facility and anesthesia fees.

Can you still feel your nipples after top surgery? ›

After surgery, you can expect your nipples to be sensitive to touch and temperature. You may also experience some numbness or tingling. These sensations will usually go away within a few weeks to months. As for appearance, your nipples will be more proportional and may be slightly asymmetrical at first.

Do puberty blockers affect brain? ›

Puberty blockers delay the start of puberty, including development of secondary sex characteristics. Surprisingly, even though puberty blockers are widely used to help transgender adolescents go through gender transition, their impact on brain function during this critical stage of brain development is largely unknown.

What is the youngest age to start puberty blockers? ›

Providers can treat precocious puberty—marked by breast development before age 8 or testes growth before age 9—with hormonal suppressants, also called puberty blockers. With supervision, these reversible drugs safely and effectively delay a child's development until they're ready.

What is the minimum age for puberty blockers? ›

You may need to wait until you are 16 to begin hormone treatment, but you may be able to take puberty blockers in the meantime.

How much does it cost to go from male to female? ›

Male to female transgender hormone therapy costs you around $30 per month. And a therapist's visit can cost you about $100.
What is the male to female (MtF) bottom surgery cost?
MtF vaginoplasty costThings to Know
$ 10,000 to $ 30,000Surgery takes approximately 4-5 hours Longer recovery process, 12 to 18 months

What is the success rate of female to male surgery? ›

Most people who choose these surgeries experience an improvement in their quality of life. Depending on the procedure, 94% to 100% of people report being satisfied with their surgery results.

Is there a test for gender dysphoria? ›

Gender dysphoria (formerly called gender identity disorder) is a diagnosis used to describe individuals who exhibit a strong desire to be of the other gender. Take this gender dysphoria test to determine if you have gender dysphoria symptoms that could lead to a diagnosis.

Which gender has more depressed people? ›

Women are nearly twice as likely as men to be diagnosed with depression. Depression can occur at any age. Some mood changes and depressed feelings occur with normal hormonal changes.

Which disorder is more common in males than females? ›

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder.

Is bipolar more common in males or females? ›

That includes the approximately 5.7 million who've been affected just in the last year alone. And while bipolar disorder affects both men and women in equal numbers, symptoms; comorbidities; rate of diagnosis; and other factors are actually quite different among the sexes.

Is there bias in healthcare gender? ›

What are the consequences of gender bias in healthcare? The overall consequence of gender bias in healthcare is that people receive worse care than they should, which increases health inequity. Gender bias causes: Knowledge gaps: A lack of inclusivity in medical research has led to gaps in knowledge.

What gender dominates the healthcare field? ›

Suffice it to say, the term “nurse” has almost become synonymous with “females in healthcare.” In fact, according to the United States Census Bureau, women hold 76% of all healthcare jobs. It should be no surprise that women have driven 80% of the overall growth in the healthcare industry.

How does gender inequality affect health care? ›

Gender bias in healthcare is an intersectional issue

Weight bias in healthcare has become a topic of greater study in recent years, and further study has shown that this, too, is more likely to affect women than men. This can lead to misdiagnosis as well as mental stress (and even eating disorders) for patients.

Can a man taking testosterone get a woman pregnant? ›

In fact, some researchers have even looked into it as a form of birth control (1). The good news for women asking “If my husband takes testosterone injections can I still get pregnant?” The answer is yes. Plenty of men with low testosterone are able to have kids, even while being treated for low T.

Can a woman taking testosterone get pregnant? ›

It is possible to get pregnant if you're taking testosterone, but it's not recommended. This is because taking testosterone in pregnancy may affect the baby's development. If you are taking testosterone and want to get pregnant, talk to the doctor who is prescribing you testosterone.

What do puberty blockers do to girls? ›

Puberty blockers are medicines that prevent puberty from happening. They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.

What to do when your daughter wants to be a boy? ›

I recommend that you start with a talk where you respectfully and lovingly let your daughter know how you feel about her gender identity and what your concerns are for her. You can also let her know what you are comfortable doing in support of her and what you are not.

Can ADHD cause gender dysphoria? ›

People living with ADHD may question their gender identity or experience gender dysphoria more often than people without ADHD. But there's no evidence to support a direct cause-and-effect relationship between ADHD and gender nonconformity.

What part of the brain controls gender identity? ›

Regarding grey matter, the main sexually dimorphic areas associated with the development of gender identity are represented by the central subdivision of the bed nucleus of the stria terminalis (BNST) and the third interstitial nucleus of the anterior hypothalamus (INAH3).

What to do if your child is non binary? ›

It's important to accept your child and let them know you love and support them, whatever their gender identity is. If you feel anxious or uncomfortable, you're not alone. Many young people and parents find talking to other parents and children who have had similar experiences a great help.

What happens if you don't treat gender dysphoria? ›

Although gender dysphoria is not a mental illness, when not addressed, it may lead to worsening mood issues, depression and anxiety, and may further complicate the issues the individuals may be having. Insurance may cover some illnesses associated with gender dysphoria and gender dysphoria care.

Can children feel gender dysphoria? ›

Children are typically diagnosed with gender dysphoria if they have experienced significant distress for at least six months and at least six of the following: strong desire to be of the other gender or an insistence that they are the other gender. strong preference for wearing clothes typical of the opposite gender.

How do parents deal with gender dysphoria? ›

Genuinely listen to your child and truly sympathize with what they're telling you. Be patient. The DSM-5 recognizes gender dysphoria as a medical condition (not a mental disorder as per outdated definitions). Your child's concerns are legitimate, backed by science, and extremely real.

What might be some childhood symptoms of gender dysphoria? ›

The key sign of gender dysphoria is that the child feels extreme emotional distress because of their gender identity. They may get anxious, depressed or suicidal because of the difference between the gender they were assigned at birth and the gender they feel themselves to be.

How can I help my 13 year old with gender dysphoria? ›

  1. Listen – Understand why they came out to you. ...
  2. Support – Respect their feelings and their choices, do not try and “convert” your teen. ...
  3. Educate yourself – if your child is experiencing gender identity issues, it is important to educate yourself.

How safe is gender-affirming surgery? ›

In general, significant complications are rare, as long as an experienced surgeon is performing the procedure. With any surgery, there is a small risk of complications, including: Bleeding. Infection.

What is the regret rate for common surgeries? ›

Overall, 13% of patients reported treatment-related regret at 5 years. This included 6% of patients undergoing surgery, 11% undergoing radiotherapy, and 7% undergoing active surveillance.

Is gender change surgery very painful? ›

However, all surgeries can cause patients some degree of pain. Luckily, pain after transgender surgery is rarely unbearable and can typically be managed with at-home treatment. After a few months, most patients will no longer experience significant pain and can begin to enjoy the benefits of gender-affirming surgery.

How many people get gender-affirming surgery? ›

About 10.9% of medical encounters of transsexualism result in gender-affirming surgeries. There is a steady rise in the number of sex change surgeries being performed annually, with a total 8304 in 2017 to a total of 9576 in 2018, with 2885 of male to female surgeries and 6691 of female to male surgeries.

How long does gender surgery last? ›

This procedure provides for aesthetic and functional female genitalia in one 4-5 hour operation. The details of the procedure, the course of recovery, the expected outcomes, and the possible complications will be covered in detail during your surgical consultation.

What is the riskiest surgery in the world? ›

Most dangerous emergency surgeries
  • Partial colon removal.
  • Small bowel resection (removal of all or part of a small bowel).
  • Gallbladder removal.
  • Peptic ulcer surgery to repair ulcers in the stomach or first part of small intestine.
  • Removal of peritoneal (abdominal) adhesions (scar tissue).
  • Appendectomy.

What is the number 1 painful surgery? ›

In general, research has found that orthopedic surgeries, or those involving bones, are the most painful.

What are the top 3 most painful surgeries? ›

For example, shoulder surgery, anal surgery, and dental surgery were associated with the highest pain scores (median NRS = 4) on the fourth postoperative day. With these types of surgeries, severe pain (NRS > 5) was noted in over 28% of patients.

How long does female to male surgery take? ›

A metoidioplasty typically takes 2–5 hours. After the initial surgery, additional procedures may be necessary. A Centurion procedure takes approximately 2.5 hours, and removing the female reproductive organs will add to this time.

What is a bottom surgery? ›

Bottom surgery refers to the plastic surgical procedures performed on the genitals to give the look—and in some cases, functionality—that matches their gender identity. Not every transgender person wants to undergo bottom surgery, but it can significantly improve self-esteem and quality of life for those who do.

How long does it take to go from female to male surgery? ›

GCS, GRS Surgery normally takes approximately 4 to 5 hours to perform depending on the complexity of the surgery.

Can transmen use Plan B? ›

Emergency contraception won't interfere with testosterone (T). In fact, trans men can use all methods of emergency contraception, including IUDs, ella, and Plan B, whether or not they're using gender-affirming hormone therapy.

What is male to nonbinary top surgery? ›

Top surgery for transgender men and nonbinary people is a procedure to remove breast or chest tissue (subcutaneous mastectomy). It's also called masculinizing chest surgery. If your chest size is small, you might be able to have surgery that spares your skin, nipple and areola.

Can gender change naturally? ›

No. Humans cannot change sex, which was determined at fertilization (genotype) and during embryonic development (phenotype).


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