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Open Letter Against Transitional Procedures for Transgender Youth

The open letter, published in the Wall Street Journal on July 13, responds to a letter from Stephen Hammes, president of the Endocrine Society, where he said that medical treatment “improves the well-being of transgender people and reduces the risk of suicide.” It referred to “life-saving, gender-affirming care,” involving the use of hormones and irreversible reproductive organ surgery, sometimes for children under the age of 18.

In their response, published this week, the group of doctors and researchers – from countries such as Finland, France, South Africa, and the United States – said that the risks associated with the use of hormones of different sex among young people “are important and include sterility, lifelong dependence on medication, and the anguish of regret.”

Several European authorities and international medical groups “now recommend psychotherapy rather than hormones and surgeries as the first line of treatment for gender-dysphoric youth,” the doctors write. They call on U.S. medical societies to “align their recommendations with the best available evidence” rather than “exaggerating the benefits and minimizing the risks.”

Among the signatories to the letter is Anne Wæhre, a senior consultant at the Oslo University Hospital. Norway is one of the European countries that have recently pulled back from offering extreme transgender treatment to youth. In early 2023, the country’s Healthcare Investigation Board demanded that Norway revise its guidelines for surgeries and hormone treatment for transgender-identifying children.

Several French doctors also signed the letter, including Céline Masson, a professor at Jules Verne University in Picardy. The French National Academy of Medicine said last year that “the greatest medical caution must be taken in children and adolescents” who claim to identify as the opposite sex.

The “greatest reserve” is required for usage of hormones in young children, noting side effects “such as impact on growth, bone fragility, risk of sterility, emotional and intellectual consequences and, for girls, symptoms reminiscent of menopause.”

In the United States, some researchers have tried to explain the explosion in young people identifying as transgender across the country and the world. In 2018, Lisa Littman, then adjunct professor at the Icahn School of Medicine at Mount Sinai, wrote a controversial report on the phenomenon of what she called “rapid onset gender dysphoria.”

In this report, Littman characterized the condition as an “onset of gender dysphoria” that “seems to occur in the context of belonging to a peer group in which one, multiple, or even all of the friends have become gender dysphoric and transgender-identified during the same time frame.”

On the other hand, major American authorities, including the federal government, have publicly supported extreme youth transgender treatments. The Civil Rights Office of the U.S. Department of Health and Social Services said last year that “gender-affirming care for minors” can “improve their physical and mental health.”

An international group of 21 doctors is calling for a change in the medical approach to gender dysphoria in children. They say the tendency to offer “transitional” treatment to children with gender dysphoria is not supported by scientific evidence and can have serious consequences.


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