The Netherlands has pioneered the adoption of experimental treatments for children with gender dysphoria – anxiety induced by a perceived mismatch between biological sex and gender identity – which involves blocking young teens’ sexual development with hormone-suppressing drugs.
But in the liberal daily newspaper NRC, journalist Jan Kuitenbrouwer and retired academic Peter Vasterman make the case for independent research in an exposé of the flaws pertaining to the approach.
“More and more is becoming known about the long-term side effects of puberty blockers,” the authors write. “They interfere with physical sexual development, hinder the development of the bones, can cause anorgasmia and infertility and interfere with the ability to make rational decisions.”
They point to studies in Sweden, Finland and the UK which have recommended psychological treatments instead of puberty blockers, which should be used only in very severe cases.
There has been a dramatic increase in the number of people seeking to change gender in the last decade. In 2010, around 200 people a year were treated at the Dutch Clinic in Amsterdam. In 2022, there were 5,000 people in treatment, 1,600 of them children, reflecting a broader rise across the Western world.
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“What we are seeing now is an entirely new type of patient,” write Kuitenbrouwer and Vasterman. “They often do not present until puberty has already started, and they often have no history of gender dysphoria. It is not a disorder, but an ‘identity’. Many have additional psychological issues – as a result of their gender dysphoria, or the cause?
The article came to the attention of Genspect, an international non-profit organisation critical of the current emphasis on transitioning in helping gender-distressed young people.
One of Genspect’s writers, Stella O’Malley, an Irish psychotherapist, points out that while it’s not known how many trans people are de-transitioning, anecdotal evidence and the 43,000 members of the Reddit thread “Reddit/detrans”, suggests the practice is not, as clinicians claim, “vanishingly rare”.
The principle underpinning the use of puberty blockers is the so-called “Dutch protocol”, an influential approach outlined in a 2006 study. As O’Malley notes, the study the protocol is based on was sponsored by Ferring pharmaceuticals, who marketed Triptorelin – a puberty blocker.
The fact this debate is taking place in the pages of the left-leaning NRC suggests assumptions are starting to be questioned in Dutch society. As to whether a shift in mood will lead to a change in practice, it’s too early to tell.