The UK just announced the launch of a randomized controlled trial to evaluate the risks and benefits of puberty-blocking drugs for minors experiencing gender distress.
The trial announcement came just days after the Department of Health and Human Services released a report on gender dysphoria treatments, concluding that offering pediatric “gender- affirming” hormonal and surgical interventions -- despite known harms and no demonstrated benefits -- runs counter to basic medical ethics.
That should be a wake-up call. Animal research suggests that blocking normally timed puberty may negatively affect cognition and brain development, and other hypothesized risks include future infertility and impaired sexual function. Yet these drugs have been prescribed for more than a decade in the absence of any reliable evidence about their long-term safety or effectiveness.
Unfortunately, here in the US, a climate of intimidation and censorship has made it difficult to ask even basic scientific questions.
The sharp rise in gender dysphoria among adolescents is a recent development. American medical organizations promote “gender-affirming care” as the presumed standard of care.
This approach includes social transition, puberty blockers, cross-sex hormones, and surgeries for minors.
For all the claims that gender- affirming care is “settled science,” there has never been any credible scientific foundation for this radical treatment approach.
The “gender-affirming” treatment model rests on a pair of Dutch studies. The studies were considered the “gold standard” for a decade. However, recent research revealed profound flaws in the studies. One of 70 study subjects died from necrosis after genital surgery -- an outcome linked to prior puberty- blocker use.
Three others suffered severe obesity and diabetes during hormone treatment. At least one discontinued transition during treatment and several dropped out and were lost to follow up.
Evidence for the long-term safety and effectiveness of these interventions remains weak. Other countries -- Finland, Sweden, the UK and New Zealand -- have sharply restricted the availability of these interventions for minors.
By contrast, in the US, scrutiny itself has become taboo. Researchers who challenge prevailing assumptions often face harassment.
A striking example occurred at Johns Hopkins University, which partnered with the World Professional Association for Transgender Health to conduct systematic reviews of hormonal and surgical interventions.
WPATH presents itself as the authority on care for gender-dysphoric youth, and for years has recommended gender transitions as the primary treatment.
Yet, court documents revealed that when WPATH officials reviewed Johns Hopkins’ evidence review and did not like the conclusions, they fought with the university and successfully blocked publication of the results.
A similar case involved Mc-Master University, who partnered with my organization, the Society for Evidence-Based Gender Medicine, to conduct independent systematic reviews. When three of the five reviews found the evidence was of very low certainty, activists launched a harassment campaign.
The pressure caused several scholars to remove their names from the remaining papers.
Recently, Washington State University’s medical school faced intense activist pressure after hosting accredited CME courses that highlighted growing international doubts about gender transitions of minors.
Although the courses had completed the accreditation process, the backlash prompted the university to withdraw them.
The problem has become so widespread that it was a central theme at USC’s 2025 “Censorship in Science” conference. Scholars warned that suppressing data, debate, or dissent -- on either side -- undermines the integrity of evidence-based medicine itself.
Suppressing scientific debate does not protect young people with gender dysphoria. It endangers them. Every child deserves care that is grounded in strong evidence, not political pressure.
Dr. William Malone is a board-certified endocrinologist and a co-founder of the Society for Evidence-Based Gender Medicine.
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