These are the kinds of young female patients with multiple mental health disorders that psychologists have been treating for years. Often these patients are dealing with anorexia, and engaging in cutting and other self-harm. But now, rather than partaking of talk therapies, they often end up being affirmed in their new gender identity, and are sometimes sent down the pipeline to medicalization—their other mental health issues ignored.

Cantor observes that now these girls aren’t just cutting their own arms; they are getting surgeons to cut off their breasts. The young people showing up at gender clinics are genuinely distressed, he said to me. “They actually do need meaningful help, but they’re not getting help for the problems they have. They’re getting help for the problems they say they have.”

As I wrote in a previous article for Common Sense, medical establishments in some European and Scandinavian countries have noticed the explosion in this population and have undertaken systematic reviews of the science on youth transition. They came away alarmed at the low quality of evidence supporting the efficacy of youth medical transition, considering how little is known about the potential side effects of these treatments—including osteoporosis, delayed brain development, sexual dysfunction, increased risk of cancer and other diseases. They also found that detransition and regret about transition were higher than expected. …

Of course, the WPATH writers had access to the same universe of information as the Europeans and Scandinavians. They acknowledge that “a key challenge in adolescent transgender care is the quality of evidence evaluating the effectiveness of medically necessary gender-affirming medical and surgical treatments.” But instead of being concerned by the paltry evidence, WPATH has falsely claimed that ​“a systematic review regarding outcomes of treatment in adolescents is not possible.” They also declare puberty blockers are “fully reversible”—but we simply don’t know their long-term impact. They reject the cautionary principle employed by other countries, and leave decisions to individual doctors and patients for any treatment—social transition, hormones, surgery.