As this story was unfolding, the Supreme Court agreed to hear a challenge to Tennessee’s ban on gender-transition care for minors. Come fall, the justices will assemble in their robes to hear lawyers solemnly argue, and next June or July they are expected to rule on whether this ban violates the equal protection clause of the 14th Amendment.
But until we have better information about how well treatments work, this makes no sense. If medical interventions help gender-dysphoric children lead longer, happier lives, then states should permit them because that’s the right thing to do, not because refusing might be discriminatory. If the interventions don’t help kids — or don’t help enough kids, and it’s not possible to reliably identify which ones benefit — then, obviously, children should not be harmed in the name of gender equality.
Maybe you think these answers are already known — that, as we keep hearing, gender-transition treatments for children are “medically necessary,” “evidence-based” and “life-saving.” But such judgments are statements of our hopes, not dispassionate assessments of the available research. Several European health authorities have conducted systematic reviews of the evidence for using puberty blockers and hormones to treat youth gender dysphoria, and all have come to the same basic conclusion: It’s too weak to know how well the treatments work.
Better evidence is urgently needed. Unfortunately, it’s becoming hard to trust the institutions in charge of gathering it. Last week The Economist reported that other documents unsealed in the Alabama case suggest something has gone wrong at WPATH itself, which reportedly commissioned evidence reviews from Johns Hopkins University, then tried to meddle with the result. Internal communications suggest that research should be “thoroughly scrutinized to ensure that publication does not negatively affect the provision of transgender health care in the broadest sense.” Now, assuming this is true, I’m sure WPATH sincerely believed it was doing its best for gender-dysphoric kids. But such meddling makes it harder to find out whether the group is right about that.
For that matter, I’m sure that almost everyone involved with the issue believes they’re doing the best thing for children, from red-state legislators who think they’re saving youth from unnecessary and harmful treatment, to HHS officials who have thought they were saving the same kids from being trapped in the wrong body. But they cannot all be correct. The two camps can sincerely hold such opposing views precisely because the issue is being treated as a political and legal dispute rather than a novel empirical question we have yet to fully answer.
The only way to resolve that question is to set aside political positioning in favor of professionalism, passion in favor of reason, and opinions in favor of facts.