The doctors who work at new “gender-affirming” clinics like Genecis say the best way to prevent these dire outcomes is to let young kids live out their gender identities however they wish — whether that’s as a boy, as a girl, or somewhere in between. They say that because gender identity is largely hardwired in the brain, kids as young as 3 can begin to articulate it, and that these kids end up happier, less anxious, and better adjusted socially the earlier we allow them to express the gender they feel themselves to be. For the small subset of kids who show a strong and consistent belief that they are a different gender, that means letting them “socially transition” to life as a full-time boy or girl.

But some doctors — as well as an unexpected mix of liberal academics, scientists, and religious conservatives — argue that we have no way of knowing with certainty which prepubescent kids who behave outside of gender norms will come to identify as trans, and which ones will not. Some worry that this approach could steer kids who are just going through a phase into a transgender “track” long before the kids know whether those feelings will really stick. Others say it reinforces outdated stereotypes — giving worried parents the false assurance that their girly boy is actually just a girl who was born in the wrong body. Conservative critics peg the increase in trans kids today to a dangerous new fad in parenting.

The most extreme members of each group have likened the other’s approach — whether pushing kids to identify as transgender or pushing them to repress their true gender identities — to “child abuse.” Unfortunately, there isn’t much hard data to help settle the debate: No study has looked at what happens later in life to kids who are allowed to socially transition before puberty.