>The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus.

Most of the evidence I've seen around transitioning is for older cohorts who were outliers in terms of their motivation to transition - most of the push I've seen is to transition younger cohorts for which the effects of transition are unknown and experimental since we are transitioning kids in populations that we never would have transitioned before. I don't think this is necessarily WRONG, just risky and experimental and requiring tracking, but I see it being portrayed as a scientific fact that putting kids on hormone blockers as preteens makes their lives better.

> A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.

Regarding the whole notion of "Transgender kids are really just confused autistics", first what is considered an Autistic child itself is a moving target since Autism is not consistently diagnosed and we diagnose autism more broadly than we did even 10 years ago and the autistic population growth is pretty rapid itself. It's hard to get insight from something poorly understood by pointing out a correlation to another thing poorly understood. Second I've seen zero evidence that autistic populations are at any particular risk of adverse effects from gender affirming treatment or whatever, this just seems to be presumed because of condescending views towards autistics and their competence to guide their own care.

>My concerns about this approach to dissenting parents grew in 2019 when one of our doctors actually testified in a custody hearing against a father who opposed a mother’s wish to start their 11-year-old daughter on puberty blockers.

Gender identity is something rather famous for changing as you hit adolescence and this is something which has been noted throughout history to the point of being ritualised in some cases, and we even have the concept of "genderfluidity", but people seem to have this very deterministic view that whatever gender identity you had at 8 years old you have forever and you should intervene early before hormones kick in. Yet fucking with somebodies hormones at like 11 years old can't help but modify somebodies natural development of their gender identity, and that makes it hard to evaluate the effectiveness of early interventions without a control. We should make the treatment open to kids from 14 up, but below that kids should with both parents consent be allowed to enter an experimental trial on the condition that some of them will be controls. Unless we do that, we're going to keep hurting kids in ignorance, either due to under treatment or over treatment.

In regards to the claims that patients aren't being informed of the risks of gender affirming care, I think political influence is fucking with proper medical care of transgender people in both directions, both outlawing supportive and sceptical medical care alike but in different areas, and I really wish politicians would frig off of such a fast changing, poorly understood, and charged issue.

Maybe this clinic is saving trans kids, maybe it's not, but I personally would like society to stop pretending that it actually understands what will happen after they subject a significantly larger slice of the population to hormone treatments at increasingly young ages when the treatment population has multiplied several times over in short-order and we literally haven't even had time to do long term retrospectives. It's an experiment being portrayed as scientifically validated best practice. I would like to see more emphasis on medical freedom for doctors, controls, and proper long term tracking and research on patient outcomes but to allow these early interventions so long as they're being conducted as ethically as possible. That way we might even be able to identify nuances like "oh, if somebody has X issue, we should be extra cautious or extra aggressive about pursuing gender affirming care"