The Increasingly Bizarre Implosion of Youth Gender Medicine Because of Political Interventions – Though Also Another Big Failure of Medicine in Self-policing Itself
By Norbert Gleicher, MD, Medical Director and Chief Scientist, at The Center for Human Reproduction in New York City. He can be contacted though the editorial office of The Reproductive Times or the CHRVOICE or directly at either ngleicher(at)thechr.com or ngleicher(at)rockefeller.edu
We in today’s posting return to the subject of whether gender-affirming treatments are appropriate for children and young adults up to age 19 years and we do so because so much has happened surrounding this subject since our Medical Director, Norbert Gleicher, MD, addressed this issue in January here in The Reproductive Times and in the CHRVOICE .
Our steady readers by now for sure know that for several reasons the CHR strongly feels that irreversible steps toward transition should not be taken in individuals under age 19. Solid data now unquestionably demonstrate that – under the age of 19 – a large percentage of youths who at younger ages considered transition changed their mind and lived relatively happy lives ever after (not different from those among us who never felt like morphing into the other sex). The CHR, therefore, strongly feels that young people under age 19 who consider transition should receive psychotherapy and other help as well as advice but not be exposed to treatments – whether medical or surgical – that become irreversible. Exceptions can, of course, be made with properly obtained consent from parents, - but only in IRB-approved study settings. The CHR, of course, fully supports transition treatments in properly consented adults.
This article, however, also now explores another issue close to the CHR’s heart as an institution and that is the increasingly frequent observed inability of the medical field in its various medical specialty areas to police itself in how clinical practice is pursued. And how medicine pursued gender transition in our U.S. youth until only relatively recently has been truly shameful and, therefore, has become an excellent example for how medicine in general has to learn to better police itself. The main reason is obvious: When and where self-policing fails, the only arising alternatives – government and/or court interventions – can have very negative consequences for patients as well as treating professionals.
When we addressed this issue over a month ago the last time, we received a ton of comments, - with a good number not being very friendly. Whether friendly or not, we love your responses. Don’t, therefore, be shy and let us know what you think!
The CHR’s Editorial Staff
This article in a much shorter format previously was published in the CHR’s Reproductive Times and CHRVOICE. It was now retitled, updated, reedited, and expanded because of significant new developments.
Several major developments in recent weeks have in the U.S. thrown into complete chaos the practice of gender medicine in children and adolescents with transgender euphoria. First, the American Medical Association (AMA) - until recently a strong supporter of such treatments - “discovered” (oh, - what a surprise!!!) that such treatments really lacked sufficient supportive medical evidence. One, therefore, is of course left wondering what the AMA’s prior support for these treatments was based on, - except, of course, for ideology and progressive politicking? In parallel, a large national surgical society came to similar conclusions, raising the question how come our surgeon-colleagues for several long years found nothing wrong with performing life-changing surgeries on gender-euphoric children who, of course – if left alone or with psychiatric/ psychological support alone – often fully normalize. And then one is left wondering about all the other related medical and non-medical professional societies which found nothing unusual about treating juveniles (at time against the will of their parents) with life changing medical treatments.
It moreover is also important to point out that – rather than self-policing the practice of gender transition in juveniles - medicine has turned this responsibility over to the courts. A first important decision came recently from the U.S. Supreme Court which – unsurprisingly at least for the CHR - found unlawful the in California (amazingly) legal practice of keeping childrens in school expressed desires to gender-transition secret from their parents. A second recent legal event may, however, ultimately turn out to have been even more impactful, - as it defined surgical reassignment surgeries at young ages as potential malpractice and, therefore, involves cold cash: A court – for the first but likely not t last time – awarded an at the time 16-year-old female who underwent bilateral mastectomies as part of her gender transition treatment the significant malpractice award of US $2 million.
Finally, we here address the most recent government interventions regarding the subject which, whether state– or federal government-driven, - almost never make much sense.
Though we in detail covered the subject of medical gender transition of juveniles already in the January 2026 issue of the CHRVOICE and in a January posting of The Reproductive Times, we – because of the importance the CHR attaches to this subject couldn’t resist here, once more, to update the subject, - considering how many important new events have happened over the last few weeks. Moreover, this subject also offers an excellent example for the lack of self-awareness and, therefore, the failure of self-policing by the medical profession in general, which ultimately can only lead to outside policing by either government or the courts. This is, of course, another prominent subject the CHR feels strongly about (just consider PGT-A in association with IVF, where – similarly after a failure in self-policing medical practice – a series of class action suits have turned over the responsibility to the courts). The CHR is awaiting your responses.
A little bit of history
It occurred suddenly, was explosive, and long overdue, - but it did finally happen: Among several other organizations, two major professional medical societies in the U.S. – after for several years having been outspoken leaders in supporting gender-affirming treatments in children and teens - offered revised public policy statements, now recommending delays to adulthood in so-called gender-reaffirming treatments which – whether medical or surgical - often have lifelong consequences. Though this reflects progress for common sense, the wording – or more correctly what was not said – is still astonishing but not surprising (and was not noted by most media outlets), - considering the societies’ prior public stance in fully supporting such treatments. Their change of mind can, however, not be considered sufficient.
Here – as quoted verbatim by The New York Times,1 the statement of the AMA:
The American Medical Association (AMA) strongly supports evidence-based, gender-affirming care for youth and opposes government interference in these medical decisions. The AMA emphasizes individualized care, typically deferring surgical procedures for minors to adulthood, while supporting access to care that improves mental health and well-being.
How shameful!
In the first sentence of this statement, the AMA basically fully reaffirmed its longstanding position of opposing all government interventions into medical practice (an opinion the CHR in principle shares, - though, of course, with exceptions: Doesn’t government through the FDA already control some aspects of medical practice? Pharma companies, for example cannot bring to market a pharmaceutical that has not previously undergone a very detailed (and often much too slow) review process by the FDA. But such restrictions do not only apply to pharmaceuticals. Organ transplantation programs in hospitals and, for example gamete donations in IVF clinics (eggs as well as semen) are closely regulated and supervised by the FDA.
But it is the second sentence of the AMA statement that makes it such a shameful document because – in it - the AMA basically pretended always to have advocated deferral of such treatments to adulthood. And that is – blatantly spoken – a lie!
In the past, the AMA to our best knowledge not even once has made the argument that juveniles should not be offered irreversible treatments to transition. One can, indeed, argue that the society aggressively supported the right of unrestricted gender transition at all ages without excluding treatments of minors suffering from gender euphoria.
The CHR, of course, fully supports the rights of adults to undergo gender transition after appropriate counseling, - but we find it reprehensible that, despite a very active visible debate (though mostly in Europe), neither the AMA nor any other major professional organization found it necessary to carve out juveniles from their support of such treatments. If considered “indicated’ by health care providers, the AMA, other professional organizations, and many major academic medical institutions, on many occasions, indeed, defended such highly consequential medical treatments and surgeries exactly under the pretext of the first sentence, - that the AMA opposes government interference into medical practice.
But what should government do when relevant medical societies, like the AMA, The American Society of Plastic Surgeons, The American College of Surgeons (ACS), The American College of Obstetricians and Gynecologists ACOG), the American Society for Reproductive Medicine (ASRM), etc., go rouge or remain silent in the face of unethical medical practices and, indeed, often support such obviously unethical and insanely illogical medical practices in their realms of alleged medical expertise?
Alleged Motivations
As already - in a Piece of My Mind article – in the January issue of the CHRVOICE suggested, the behavior of organized medicine regarding gender reaffirming medical care of minors has brought shame on all of U.S. practice of medicine. That above quoted statement – even as of this point - is all the AMA is willing to offer is, indeed, quite astonishing. Where is the loud and clear “mea culpa, - we are sorry it took so long” – and only further demonstrates the reckless politization and resulting moral as well as ethical bankruptcy of much of organized medicine in the U.S. How gender transition in juveniles has been handled by organized medicine was, very obviously, not accidental and/or unique. How the COVID-119 pandemic was handled is likely the most obvious general medical example; but the infertility field is not lacking examples either. Just consider how organized medicine has been handling preimplantation genetic testing for aneuploidy (PGT-A) over more than two decades (more on that later).
According to REUTERS,2 the American Society of Plastic Surgeons in its statement – like the AMA – now suddenly also concluded that surgeons should in gender-euphoric youths delay gender-related breast or chest, genital, and facial surgeries until a patients is at least 19 years old. The cited reason, - once again of course “lack of evidence supporting the procedure’s benefits.” But if there is lack of evidence now, there was evidence lacking from the beginning. Where has this society of surgeons, therefore, been over so many years during which thousands of children were irreversibly surgically damaged by so many of this society’s members?
And once again, of course no “mea culpa,” no regret!
Nothing, therefore, has very obviously been learned from this ethical as well as clinical disaster, which just resulted in a first million-dollar legal judgment against a psychologist and a plastic surgeon for driving a 16 year-old girl toward a bilateral mastectomy while undergoing gender transition and – as THE FREE PRESS reported - “leaving her disfigured for life.”3 If one does not recognizes one’s errors, one is predestined to repeat them (after a quote from the Spanish-American philosopher George Santayana in his book The Life of Reason, published in 1905).4 It seems high time to recognize our errors in this matter, acknowledge them, and change practice!
Many more such trials are on the way and even much bigger pay-outs can be expected, likely also including major medical institutions (often affiliated with famous medical schools and/or universities) that often not only tolerated such practices but even encouraged them. And the motivation(s)? Besides an obvious need for political correctness, these institutions (and the involved clinical psychologists as well as physicians), of course, had unlocked a significant new revenue source, and established yet another new “medical specialty” in which they could present themselves as “experts.”
In a posting on January 31, 2026, on X, Elon Musk – in our opinion correctly - predicted that “there will be thousands of court cases of children who were mutilated by evil doctors, modern day Mengele” (the infamous physician at Auschwitz who experimented on the bodies of Jewish prisoners). While the analogy to Mengele is obviously an inappropriate exaggeration that minimizes Mengele’s human deprivation, it is telling that such an alleged associations can even see the light of day.
Since its existence the CHR has warned about too much government intervention into medical practice; but we have also for decades argued that - whenever medicine fails in policing itself - government not only will, but must, intervene. As the COVID-19 pandemic (among many other valid examples) again so well demonstrated, government is, however, not very good at intervening. While there, of course, are many good reasons why medical practice should not allow to be dictated by government, - a main reason is that every decision then inexplicitly involves politics. And political considerations, of course, only very seldom concur based on biological facts. Yet, as the public discussion about gender transforming care in juveniles has evolved, politics have clearly gotten out of hand, and the last few weeks have been especially telling.
The Increasing Impact of Ideology and Politics on Medicine
Here is the paradox: Though everybody in organized medicine claims to oppose government interventions into medicine, political ideology has never before been as influential in medicine as it is now and that impact – if anything – is still growing. To a degree this is not surprising because force always elicits a counterforce. Following a quite radical progressive Biden administration, the current conservative Trump administration is now determined to counteract perceived ideologically and politically motivated interventions into the U.S. health care system by the Biden administration. And the end result is a swinging pendulum that goes from one extreme to the other.
Though by no means the only political and/or ideologically-driven medical treatment discourse medicine currently faces, gender-bending medical care of children has – nevertheless – become the, likely, most visible and – for that reason - also most telling examples demonstrating the dangers of ideology and politics becoming the basis for medical decision-making. In opinion polls a so-called “80:20 issue” (80% against, 20% for gender-bending treatments of juveniles ) – it being at the center of such a volatile political dispute between political right and left - does not really make much political sense. And for states, like California, passing laws prohibiting teachers from informing parents when their children in school are transforming from Michael to Michaela (or vice versa) seems like pure insanity, as most recently fortunately reaffirmed by the Supreme Court (more on that below).
The sad thing, however, is that we physicians allowed this insanity to enter medical practice. That life-changing and irreversible treatments for gender euphoric children would ever be considered acceptable by medical practice, professional societies, hospitals, and academic institutions is, therefore, deeply disturbing (equally disturbing is, of course, that teachers’ unions have been aggressively supporting above-noted California law that until a recent Supreme Court decision supported the notion that teachers should keep secret from parents their children’s gender transition efforts in school). One, indeed, does not even have to be an educated medical service provider, psychologist or ethicist to understand how illogical – and purely stupid – it is to ask children for informed consent to receive puberty blockers and have major surgeries like mastectomies and/or other irreversible surgeries or medical treatments.
Similarly, it seems almost incomprehensible that – as now widely revealed - parents were literally forced into giving consent on behalf of their children for such totally unsupported treatments under false pretexts. Many were falsely told that their children otherwise would commit suicide and/or were threatened to be accused of child abuse if they refused such life0changing treatments for their children (more on that below).
Medicine (and with it the AMA and other medical societies) over the last 40 years has transitioned from a politically very conservative field into a politically highly-progressive profession and, in the process, has abandoned objectivity under the influence of ideology. This is very obviously a generational shift, seen not only in medicine (journalism is another very good example). What makes this shift in medicine, however, so peculiar is the fact that medicine during these decades has increasingly argued in favor of so-called evidence-based (i.e., data-driven) ethical medical practice. Only the break-out of a pandemic of ideologic reconsiderations, therefore, can explain previously noted “sudden” recognition by AMA and the Society of Plastic Surgery that gender-bending treatments of children have no evidence to support them.
And just to be unbiased and complete, where have our professional societies been hiding when it comes to this subject? Where are ACOG, ASRM/SART, and where is ESHRE?
Organized medicine thus does not want a conservative government to insert itself into medical decision making, - but with open arms welcomes so-called progressive ideas into medical practice, - gender bending medical care of juveniles, of course, being a prime example. As a consequence, a radically progressive social ideology has in most aspects driven gender transition practices, - however lacking even minimally required scientific evidence.
Why Most Legacy- as Well as Social-media Have Been In-cahoots
And then there are, indeed, public media, - without which neither ideology nor politics can exist, but which increasingly have lost their common sense. It, therefore, should not surprise that for the longest time – with incredibly few exceptions – media in general ignored the here addressed subject, - until it basically was no longer ignorable.
Above noted AMA and Society of Plastic Surgery statements about gender transition treatments of juveniles, therefore, were all over old and new media. Both in their superficiality, however, at least initially mostly only addresses the surgical transgressions of the field, - while completely missing that the statements of AMA and the surgery society basically avoided to address, - non-surgical gender transition treatments like puberty suppressing drugs which, of course, also can have devastating life-long physical effects on children, - not even to mention their psychological effects.
Those recently were extensively discussed in an excellent review article from Sweden.4 Why, for example, has there been almost no discussion in the U.S. about differentiating between children with true gender euphoria and only TikTok-socially-infected children? Where have been the professional societies of clinical psychologists and psychiatrists whose members, as part of “transgender medicine teams.” often offered highly biased psychological and psychiatric counseling.
Calling themselves mental health professionals, - so many among them shamefully reaffirmed children in often TikTok-derived euphories, rather than warning them about premature conclusions regarding their often only momentary artificial social euphoria. These professionals (or wouldn’t it be more appropriate to call them pseudo-professionals ), therefore, ended up driving many of these gender-euphoric youngsters toward lifechanging treatments they later ended up deeply regretting.
And to remain polite - these pseudo-mental health providers often also treated the children’s parents shamefully when indoctrinating often totally unprepared parents with almost unimaginable falsehoods. As already noted above, the worst according to later appearing repeated public statements by so-affected juveniles, likely was the claim that - if not offered these treatments - their children likely might commit suicide. Hearing this from alleged “experts,” - often “famous professors” at major medical schools - one can easily imagine the impact.
The real shame for these pseudo-professionals, however, lies in the fact that the literature actually suggests exactly the opposite: It suggests that suicides in gender-bending youth is actually rare. A recent Finish study, indeed, reported that clinical gender dysphoria does not appear to be predictive of either all-causes of death or of suicide mortality when psychiatric treatment history is accounted for.5
On a relevant side note, - isn’t it interesting that most papers on the subject of treating gender euphoric youths have come from Europe. This, of course, also includes the so-called Cass Review in the UK ,6 - frequently before discussed in these pages and, undoubtedly, mostly responsible for the counterrevolution against gender determining treatments of juveniles.
And returning to the media, supposedly interested in society’s wellbeing yet, at least initially, almost unanimous in agreeing that government should not intervene in this matter. In almost all cases, legacy- and/or social-media were, indeed, in full agreement with schoolteachers and their unions, which often encouraged and facilitated gender transition of pupils in schools behind their parents’ back and, of course, in a huge majority supported unrestricted treatments of transitioning youngsters at all ages.
Originally led by who-else but The New York Times, the newspaper’s management in 2020 - after the George Floyd events - formally announced a major change in its longstanding reporting and publication traditions by moving from offering “objectivity” (or “neutrality) in information in the news section of the newspaper to “independence,” “fairness,” and “truth.” A. G. Sulzberger, publisher of the newspaper, has been quoted as saying that “independence” is a better descriptor of the newspaper’s goal than “objectivity,” which The Times now argues can be misunderstood as “both-sideism.” This word alone is, of course, in a way symbolic of The Times’ seemingly steadily increasing arrogance as the nations’ principal change agent (for U.S. history, the 1619 Project; for the ethics of journalism above quote by Sulzberger; and for changes in the English language, ”both-sideism”). What a word!
While Sulzberger’s comments on first impression may seem like an unimportant word-salad, they had a major impact not only on The Times, - but on almost all media because, if the world-famous Times (“Everything That’s Fit to Print”) acknowledges that objectivity/neutrality no longer matters, why should it continue to matter at other media outlets?
The media world was at that point, of course, already anything but perfect (which it really never was) and severely contaminated by ideological and political biases; but media organizations were at least still attempting to hide those. After Sulzberger’s comments especially the younger generation of journalists, however, suddenly perceived themselves freed from the shackles of objectivity and embraced by the ideology of the neo-Marxists of the Frankfurt School who likely represented a majority of their college faculty and always had taught them that objectivity equaled discrimination, for as long as one did not consider whether it involved the suppressed or the suppressors. And under such a viewpoint (and, of course fully compatible with Sulzberger’s statement), personal biases not only had no longer to be avoided in reporting the news, but were, indeed, the right way to see and report the news.
But the ideas of the Frankfurt School did not only penetrate journalism. They penetrated all relevant studies of higher learning, of course including the study of medicine. In short, the changes we above described to have taken place within the journalism field also affected the medical field. Here too, the conclusion reached was that biases were not only allowable but morally and ethically “the right thing to do.” Personal opinions of right and wrong, reflecting what individuals considered independence, fairness, and truth, therefore, entered the businesses of medicine and journalism roughly in parallel.
And the consequences, of course, also were similar: On the journalism side, CNN and FOX News ended up presenting news as often outright opposing realities of the world. On the medical side, whoever held political power decided what was good medicine (and how poorly that works we by know from many examples, starting with the management of the COVID-pandemic, which demonstrates greatly varying outcomes in countries, - not dependent on overall quality of medical services, - but based on what political etiology was ruling).
While in an objective and balanced environment the absolutely ludicrous idea of unrestricted transgender medical care for minors – at times even behind their parents’ back – would likely not even be seriously considered, in an atmosphere of radical diversion between political left and right, the idea not only garnered a substantial following on the left ideologically evolved into a core issue.
The one media outlet that broke many news stories on the subject was THE FREE PRESS (as then almost every time reported by the CHRVOICE since this subject has been closely followed at the CHR for years). On February 1, 2026, however, everything changed when Varian Fox - at time of her mastectomies only 16-year-old - was awarded US$2million in damages. Suddenly however, many more media outlets – beforehand completely disinterested in the subject – discovered the issue of gender medicine in children and young adults as a subject of interest, - among them, of course, The New York Times..7 But the title of an article in THE FREE PRESS once again said it best: “A Legal First That Could Change Gender Medicine.”8 And, since this legal judgment for the first time established significant financial risks for practitioners and hospitals, we are convinced that it, indeed, will finally change the practice of gender medicine in juveniles in this country.
The in the Debate Still Missing Professional Societies
As already noted, medical societies in general have so-far mostly either remained absent from the debate or – after initially proactively supporting the practice of treating juveniles – have fallen silent. A good example is the American College of Obstetricians and Gynecologists (ACOG) which historically has supported access to gender-affirming care for transgender and gender-diverse youths and has remained silent on the issue since 2021.9 In other words, ACOG has failed to at least update the society’s universal (i.e., unrestricted) support for all evidence-based care of juveniles, even though, for example the AMA – as noted above – has clearly recognized that much of widely practices care juveniles had received was not evidence-based.
Yet, amazingly, by not having updated its 2021 policy statement on the subject, ACOG still basically claims that such care does represent “individualized evidence-based care.” Its 2021 policy statement has still not been recalled and/or replaced and also pointed out similar statements of other professional societies, including mainstream societies like the Endocrine Society, and the Pediatric Endocrine Society, and obviously potentially economically conflicted societies like The World Professional Association for Transgender Health, - all of which like ACOG – have not yet updated their policy statements. We here reprint the section affecting adolescents in the 2021 ACOG policy statement:
Medical care and community support that affirms adolescents’ gender identities improves the health and lives of transgender and gender diverse young people.
• Adolescents must be able to live openly and consistent with their gender identity, without fear of stigma, discrimination, or retaliation from clinicians, support systems, schools, communities, and elected officials and other policymakers.
• Health care professionals can play an important role by creating a welcoming, confidential clinical environment, where adolescents can openly discuss issues and needs, including sexual and reproductive health, disclosure of gender identity to their families and communities, community resources and support, and gender transition care.
• ACOG joins major medical associations in supporting access to evidence-based gender affirming care for transgender youth, free from political interference.
• Medical experts in transgender care, including the World Professional Association for Transgender Health, the Endocrine Society, and the Pediatric Endocrine Society, have published guidelines on how best to care for transgender adolescents, including the provision of gender affirming care.
• There is no uniform transgender experience. Each individual will desire different outcomes, underscoring that as with all care, health care and counseling for transgender youth should be individualized, confidential, evidence-based, and free from discrimination and government interference.
• Health care professionals alone cannot provide the support transgender adolescents need.
And we, of course, are also still missing our principal professional societies in the infertility field in this debate: Neither ASRM nor ESHRE – to the best of our knowledge after literature searches – have ever addressed here discussed issues. One really wonders how that can be!
As the gaps between political left and right have increasingly become more pronounced, this likely reflects a politically understandable strategy for many professional societies but, on an ethical and professional level, seems cowardly since - after all - the first rule of medical practice is, “to do no harm.”
And doesn’t this rule also apply to medical societies?
That so many relevant societies have remained silent on the subject is, therefore, disappointing.
Considering the widening gap between opinions, we found a relatively recent statement by the European Academy of Paediatrics of interest because it succeeded in directing the attention toward inappropriate treatments in adolescents by pointing out that treatments like pubertal suppression and administration of cross-sex hormone in children and teenagers require more research. The society thus basically acknowledged that current evidence was insufficient. Since this opinion – overall – was well written, we below reprint the document’s abstract summary.10
Gender issues have become a polarized and political subject in modern pediatrics and indeed, in broader society. These include the management of infants with disorders of sex development and transgender sports participation, but especially recently regarding the management of gender dysphoria. The European Academy of Paediatrics (EAP) acknowledges that there are deeply held beliefs about this issue based on conscience and social norms. Several European countries, led by the UK, have recently reviewed the management of gender dysphoria in children and young people. Recognizing the need for far more research into treatments such as pubertal suppression and cross-sex hormones in children and young people, we review the current ethical and legal dilemmas facing children with gender dysphoria, their families and the clinical teams caring for them. We suggest an approach that maintains the child’s right to an open future whilst acknowledging that the individual child is the crucial person affected by decisions made and must receive appropriate support in decision-making and care for any associated mental health or psychological issues. Noting that national approaches to this vary and are in flux, the EAP advocates a child-centered individual rights-based analytical approach.
And the Latest Developments
When – as noted above - the Trump administration, under the threat of cutting Medicare reimbursement to hospitals for non-compliance (including in New York State) published a U.S Department of Health and Human Services order to disallow gender-affirming treatments in children and young adults, New York State Attorney Letitia James, JD, - based on past public pronouncements during her first election campaign and her later legal actions against President Trump personally not a Trump-lover – in return threatened New York state’s hospitals with lawsuits if they complied (we will return to this point below). But, as the media started to better understand that U.S. gender medicine had reached a point where it had to choose between a collapsing consensus within the medical community on pediatric and adolescent transition treatments and children’s’ well-being, - the interference by blunt politics started to get out of hand.10
Glenna Goldis, JD, reported in THE FREE PRESS her own personal story of how she - a progressive lesbian and specialist prosecutor of consumer fraud in the New York State Attorney’s office – was fired by James because she participated in a public demonstration that had called out gender affirming care in minors (see picture below).7 New York’s States Attorney therefore - quite obviously - feels strongly that minors should remain subject to gender-changing treatments.
But – unfortunately quite obviously only based on legal and financial rather than ethical and humanitarian considerations - NYC’s hospital industry apparently did not stand with James on this issue. On February 16, 2026, NYU-Langone Health, one of the city largest hospital network which also includes the city’s currently highest ranked medical school, publicly announced that it had discontinued its gender-affirming medical program for minors.
And this decision did not only include stoppage of debilitating surgeries, - but also meant for patients under age 19 cessation of puberty blocking treatments and other hormonal therapies. According to media reports, this decision was driven by “the current regulatory environment” (no kidding!) and threats of federal funding loss under new executive orders.8 But – if we have to guess - it may have been more influenced by – as already noted earlier - a court for the first time awarding US$2 million in malpractice damages to a 16-year old whose breast were removed as part of gender reassignment treatments she received.3
Gender-affirming care for adults, however, continues at NYU, and we see nothing wrong with that. How sad, however, that NYU could not bring itself to simply stating that the hospital was just trying to do the right thing when it comes to the treatments of children and adolescents!
Instead – obviously in view of the political landscape in the city of New York and the state - the institution practically apologized for the decision, - suggesting that it was forced upon NYU by the Trump administration’s executive order. The CHR, of course, wished NYU, instead, had apologized for allowing for so many years this kind of medical care within its walls in the first place.
But you have to give it to the NYU administration, they do know their city and state government because only three days lafter announcing the closing of the program on February 20, 2026, NYS Senator Kristen Gonzalez shot off a threatening letter to NYU Dean and CEO, Robert L. Grossman, MD, under the heading, - “73 NY Legislators Demand NYU Langone Reverse Discontinuation of Youth Gender-Affirming care Program, in letter led by NYS Senator Kristen Gonzalez.”9 And we here quote from the press release announcing the letter:
Earlier this week, NYU Langone announced their decision to capitulate to the Trump Administration’s discriminatory anti-trans agenda and discontinue their gender-affirming care program for youth. New York State Senator Kristen Gonzalez (D59), who represents the hospital, led a letter sent to Dean and CEO of NYU Langone Health, Robert L.Grossman, demanding that the hospital reverse this decision, and stand with the trans community. Assemblymember Jessica Gonzalez-Rojas and Councilmembers Tiffany Caban, Chi Osse, and Virginia Maloney circulated the letter in the Assembly and City Council, and 73 legislators across New York have signed on.
The letter states that in addition to the harm the discontinuation of the Youth Gender-Affirming Care Program will have on New York families, it may also be in violation of New York State human rights Laws–a claim supported by New York Attorney General Letitia James’s advocacy on this issue.
And it, indeed, did not take very long for New York state’s Attorney General to follow up with her own threatening letter to the NYU-Langone administration, demanding that the hospital resume gender affirming care for minors.9 The poor NYU administration now finds itself caught between opposing legal demands (and, therefore, of course financial threats) from federal and state governments.
But NYC and New York state are, of course not alone in opposing the Trump administration on this issue: California also appears to continue supporting the concept of transgender care for children and juveniles because – as just reported by Jill Cowen in The New York Times – California sued the largest health system for children in the state, Rady Children’s Health, to prevent it from ending gender-related treatments for transgender young people. The state’s attorney general, Rob Bonta, JD, (remember his name!) in a lawsuit claimed that the hospital system had violated a legal agreement with the state by unilaterally deciding to stop providing hormone treatment and other gender-related health services to patients under age 19.11
It is remarkable how illogical and inhumane politics can get, - incited by nothing else but political hunger for power. And culpability lies, of course, on both sides of the political spectrum because – as much as the two state attorney generals have no business in telling hospitals how to practice medicine - so doesn’t the Trump administration. Which brings us to a point the CHR has been making and advocating for years, - if not decades: When the medical field fails in self-policing itself, government will - and indeed, must of course – insert itself as a last resort and that then becomes the kind of political mess we are now observing here. Once this point is reached, what is best for medicine - in this case what is best for children - no longer matter because under such circumstances only political ideology rules.
.
But things, of course don’t need to end this way. Europe in this case offered a much better alternative which started with the British medical community authorizing the so-called Cass Review, a several years-long scientific review of the medical literature led by a prominent academic pediatrician which concluded that – then widely practiced treatments for gender change were not sufficiently evidence supported to continue them.6 Though not everybody agreed with this principal conclusion (as is, and should be, the case with practically any scientific publication) medical communities (as well as governments where applicable, - though in most countries those were decisions made by the medical field) agreed that – considering medicine’s first ethical rule of “doing no harm,” these treatments must be stopped. And that is exactly what happened throughout Europe!
Note the difference: no need for interventions by government dictum, and no opportunity for political grandstanding by attorney generals (though Six European Union countries have outlawed “unnecessary” surgeries, including Malta, Germany, Iceland, Greece, Spain, and Portugal). Reflecting the importance of “first do no harm,” it is remarkable that – in contrast to the U.S. – liberal Scandinavian countries were especially proactive in prohibiting gender transition treatments in juveniles. What does this say about our supposedly liberal states, like New York and California which are the strongest supporters of transgender care to juveniles?
A very well written summary by Emily Yoffe, a senior editor at the publication, on the rise and fall of youth gender medicine worldwide, including of course, the U.S., was presented in a recent article in (where else?) THE FREE PRESS, - under exactly that title.12
And also related and very timely, Amanda Lock Swarr in Science13 reviewed a book by Iain Morland who she calls – arguably – the foremost theorist of critical intersex studies (see article below). The title of the book is “Intersex” and Moreland’s key criticism of current clinical practice is that - “… regardless of outcome, intersex is never erased by surgery.” The question then, of course, becomes, why would anybody expect surgery to work in transgender situations (see below)?
After President Trump on January 28, 2025, signed earlier noted executive order under the title “Protecting Children from Chemical and Surgical Mutilation,” which restricted access to gender affirming care to individuals under age 19 – with considerable delay in comparison to most of Europe - at least some sanity appeared to have entered the realm of juvenile gender transition treatments in the U.S. According to several media reports approximately 21 to over 40 hospitals have in the U.S. since paused or ceased gender affirming care to minors, among those – besides NYU-Langone – other well-known academic institutions, like Children’s Wisconsin, Children’s Hospital Los Angeles, and Children ‘s National Hospital in Washington, DC.
A report in The New York Sun claimed that Medicaid spent more than US$100 million over the last five years on gender treatments and surgeries for minors.14 Other reports by recently more interested media regarding this subject extensively reported on a Supreme Court Decision in early March (Mirabelli vs Bonta/Olson) which blocked a California law that allowed schools to conceal a student’s gender transition in school from her/his parents. Amazingly, California state law supported this and it took this landmark decision on March 2, 2026 by the U.S. Supreme Court to end this outrage:15 The Court in a 6-3 ruling (what did the 3 judges who voted against this opinion really think?!) held that the state of California cannot keep student “transgender” identities secret from parents, with the argument being that the secretive policies likely violate the First Amendment rights of the children’s parents.
Because Christian teachers and parents were the parties challenging the California law in court, the uber-liberal New York Times –– reported on the Supreme Court’s decision under the headline, “Supreme Court Sides with Religious Parents …”16, - as if gender transition of juveniles was just a religious issue. It, of course, is not only a religious issue but an in principle ethical and humanitarian issue which, unfortunately, has also become a divisive principally political issue between left (pro) and right (against) that over the years has assumed absurd proportions. In conservative Texas the conservative attorney general (who is also running for the Senate) threatened “consequences” to Texas health professionals – whether physicians or therapists – who facilitate “those radical procedures.”17
Summary and Conclusions
In short, how children and young adults up to age 19 should be medically treated if they - for whatever reasons - are considering a gender transition is up in the air. The principal reason is that the medical field has allowed political ideology rather than medical evidence to dominate the discussion. If one were to follow the “first, do no harm” principle, there – like in Europe – the matter would have been settled a long time ago because - considering the time this dispute has remained unresolved is evidence enough that currently available evidence levels for almost any treatments besides psychotherapy are insufficient. Consequently, none of these treatments should be offered outside of properly (by parents) consented clinical trials.
Because the medical establishment, due to very obvious political interreferences and motivations, cannot agree on this common sense and in medicine basically routine standard of care, the definition of what standard of care should be, - is being farmed out to the court system, with every aspect likely reaching the Supreme Court. And this is not only deplorable but – frankly – to a significant degree undermines the already very much weakened authority of the medical health care system after the COVID-19 fiasco.
But – whether for the good or bad – while the Supreme Court will ultimately define the relevant legal principles of gender transition treatments in minors, the court system will at much lower court levels affect medical practice in this arena in an also even more important way, - through malpractice suits!
As Elon Musk correctly noted, following the recently successful first case in which a young female plaintiff who underwent a bilateral mastectomy at age 16, was awarded US$2 million in damages, there will be hundreds, - if not thousands – cases like this filed all over the country which will keep the court system busy and active practitioners in the field and the clinics, hospitals and surgery centers that support these practices on their toes. And we, indeed, predict that these court cases will be more effective than the big Supreme Court cases in stopping irresponsible gender transition treatments in their tracts.
But this is, of course, anything but good news, because does medicine really want to turn over how we practice medicine to the courts? And the here presented circumstances regarding gender transition are, as we in the infertility field have recently learned, not the only example. Just think about the multitude of class action suits filed recently all around the country by attorney against PGT-A (preimplantation genetic testing for aneuploidy) laboratories.18 There, too, the CHR for many years has been warning that the IVF field, ultimately, will either face an intervention by government (FDA) of from plaintiff lawyers. And the latter – the worse of the two risks – now already happened, - just because medicine cannot police itself!
REFERENCES
The New York Times. February 4, 2026. https://www.nytimes.com/2026/02/04/health/gender-surgery-minors-ama.html
Sathosh C. Reuters. February 3, 2026. https://www.reuters.com/business/healthcare-pharmaceuticals/us-plastic-surgeons-group-advises-delaying-gender-surgery-until-age-19-due-2026-02-03/
Ryan B. The Free Press, February 1, 2026. link
Linander I, Lauri J. Social Health Illn 2026;48(2):e70141
Ruuska et al., BMJ Ment Health 2024;7(1):e300940
The Cass Review. Final Report. Archived June 20, 2022. https://webarchive.nationalarchives.gov.uk/ukgwa/20250310143829/https://cass.independent-review.uk/about-the-review/
Goldis G. The FreePress. January 27, 2026. link
Jacobs A. The New York Times. February 3, 2026. https://www.nytimes.com/2026/02/03/health/gender-surgery-malpractice-varian.html
Press release, Kisrten Gozalez. February 20, 2026. https://www.nysenate.gov/newsroom/press-releases/2026/kristen-gonzalez/73-ny-legislators-demand-nyu-langone-reverse. Accessed March 7, 2026
Offenhartz J. AP. March 3, 2026. https://apnews.com/article/nyu-hospital-letitia-james-trans-3d6b918fd7b084642698cb8246bec0d2
Cowan J. The New York Times. February 8, 2026;p14. https://www.nytimes.com/2026/02/06/us/california-children-hospital-transgender-care.html
Yoffe E. The Free Press. February 5, 2026; https://www.thefp.com/p/the-rise-and-fall-of-youth-gender?utm_source=substack&publication_id=260347&post_id=187025125&utm_medium=email&utm_content=share&utm_campaign=email-share&triggerShare=true&isFreemail=false&r=5dj1m5&triedRedirect=true
Lock Swarr A. Science 2026;391(6780):p31
Ryan B. The New York Sun. Updated February 26, 2026. https://www.nysun.com/article/medicaid-spent-over-100-million-in-five-years-on-gender-treatments-and-surgeries-for-minors-government-investigator-finds
Clancy K. Liberty Justic center. March 3, 2026. https://libertyjusticecenter.org/newsroom/u-s-supreme-court-delivers-historic-groundbreaking-victory-for-parental-rights-dismantles-californias-secret-gender-transition-regime/
Marimow AE. The New York Times. March 2, 2026. https://www.nytimes.com/2026/03/02/us/politics/supreme-court-california-trans-students.html
Cortright B. The New York Sun. March 3, 2026. https://www.nysun.com/article/texas-mental-health-professionals-prohibited-from-providing-radical-gender-transition-treatment-to-minors
Duchame J. Time. March 6, 2026. https://time.com/7264271/ivf-pgta-test-lawsuit/