The Economist — The evidence to support medicalised gender transitions in adolescents is worryingly weak (2023)
On 5 April 2023, the British weekly magazine The Economist published the background article The evidence to support medicalised gender transitions in adolescents is worryingly weak in its Briefing section. The article examines the scientific basis for puberty blockers, hormones and surgeries for teenagers with gender dysphoria.
Key points
The magazine points out that a British health authority assessed the available research as weak and partly contradictory. The original Dutch studies behind the Dutch Protocol had no control group and limited follow-up. Moreover, the current patient population differs from the group in that initial research: clinics now mainly see teenage girls whose dysphoria has developed recently, and a large proportion of referred young people also have mental health problems.
The article also notes that virtually all young people who receive puberty blockers subsequently go on to take hormones, raising the question of whether the blockers genuinely provide time to think. Estimates of the number of people who discontinue treatment vary widely. Health authorities in, among other places, the Scandinavian countries have become more cautious.
Figures and examples
The article opens with three young American women who have reversed their transitions: Prisha Mosley, Luka Hein and Chloe Cole. It then presents figures. According to the magazine, more than 42,000 American children were diagnosed with gender dysphoria in 2021, three times as many as in 2017. Around 5,000 teenagers were prescribed puberty blockers or sex hormones that year, twice as many as in 2017. On the number of people who stop treatment or come to regret it, the article cites varying findings: some studies arrive at 1 percent, while studies from 2021 and 2022 put the figure at 7 to 30 percent. More on this subject can be found under detransition.
The studies discussed
The British authority referred to by the magazine is NICE, whose assessment is included in this archive as the NICE review. The article also mentions Finnish and Swedish assessments with similar findings. The Dutch studies are those by Annelou de Vries and colleagues from 2011 and 2014. The magazine also discusses an American study by Chen and colleagues from 2023, published in the New England Journal of Medicine, which found small improvements in psychological well-being but had no control group. The literature reviews by the Endocrine Society and WPATH are criticised for being incomplete.
Differences between countries
The article contrasts two groups. Medical organisations in the United States support the treatment, while health authorities in Great Britain, Finland, Sweden, Norway and France have expressed reservations. A number of US states, including Florida and Utah, have banned the treatment for minors. How media in different countries covered this same news is compared by gendermedia.nl in the article on international media and the framing of gender healthcare. The country-by-country overview can be found under policy by country.
Why it is included in this archive
The article is a widely read journalistic summary of the international developments of that year. It is behind a paywall.