Biden's gender transition proposal cements school-to-clinic pipeline

Schools should not make medical decisions for students

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In July, the Department of Education’s Office for Civil Rights (OCR) published a proposal for new rules under Title IX of the Education Amendments of 1972. If passed, the rules would, among other things, ramp up the pressure on school districts to adopt policies that will facilitate students’ gender transitions, even without the knowledge or consent of their parents. This marks a disturbing twist in the continuing saga of Title IX expansion: under the political cover of "civil rights," the Biden administration is cementing the school-to-clinic pipeline.

The term "social transition" refers to the use of a person’s preferred name and pronouns and granting access to sex-specific accommodations like restrooms and sports teams that match that person’s "gender identity." Researchers, clinicians, parents, and detransitioners (people who began or completed medical gender transitions but changed their minds and sought to reverse the process) have noted the self-fulfilling prophecy of social transition. 

"Affirming"—that is, agreeing with and supporting—a minor’s rejection of his or her body in favor of an alternative "gender identity" increases the chances that what would otherwise very likely prove to be a temporary phase of confusion or distress will become a more permanent state of mind, i.e., an "identity." Studies examining the rates of desistence/persistence of gender dysphoria in prepubertal children have found that the vast majority (some two-thirds to 98 percent) desist by adolescence or early adulthood on their own or with counseling. 

Many medical professionals, including Hilary Cass, the former president of the U.K.’s Royal College of Paediatrics and Child Health, have raised concerns about social transition. Using a minor’s preferred name and pronouns to validate his or her "gender identity," Cass observed, should not be considered "a neutral act" but instead an "active intervention" in a child’s psychosocial development. 

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An "affirmed" child reaching the Tanner II stage of physical development—typically between ages nine and 13—in a state of gender dysphoria will likely go on to receive puberty blockers, especially given the widespread (but false) assumption that these expensive drugs are "fully reversible" and merely buy some time for self-reflection.

Three studies completed over the past four years show that 96 percent to 98 percent of those who begin puberty blockers go on to cross-sex hormones, an intervention that often entails permanent loss of fertility and sexual function in addition to heightened risk of cancer and heart disease.

The U.S. Department of Education building in Washington, D.C. 

The U.S. Department of Education building in Washington, D.C.  (STEFANI REYNOLDS/AFP via Getty Images)

In practical terms, then, when a school strives to create a "safe, welcoming, and inclusive" environment for transgender-identified students, it increases the chance that children who might otherwise go through a temporary stage of identity exploration or confusion will reject their bodies in favor of a risky experimental medical protocol. A teacher’s expression of kindness and desire to be inclusive could have serious unintended consequences. Given mounting evidence of the socially contagious nature of transgender identification among teenage girls with preexisting mental health conditions, parents are right to worry about the new Title IX rules.

The OCR’s vague Title IX rules do not define the key term "gender identity," or specify when and under what circumstances schools are to involve parents in decisions regarding student gender transition. Fearing OCR investigations and civil rights lawsuits by groups like the ACLU and Lambda Legal, risk-averse school administrators face strong incentives to let transgender advocacy groups dictate their internal policies. Having adopted policies that most parents would find inappropriate—including use of a student’s preferred name and pronouns without parental knowledge or consent—many school administrators work to conceal those policies from parents. 

Teachers and school administrators have neither the expertise nor the authority to make medical decisions for their students, especially when those decisions could have lifelong implications. Such decisions should be entrusted to parents or legal guardians alone, in consultation with a physician. After all, parents are the people most invested in their child’s well-being, understand his or her evolving needs the best, and will bear the long-term consequences of any decision.

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Because Democrats and school officials invoke medical authorities to justify their unpopular policy choices, the current gender woes in our schools will probably not go away until medical professionals and organizations begin to face serious consequences for their refusal to follow the evidence. State and federal lawmakers are currently weighing bills that would extend statutes of limitations for medical malpractice suits to 30 years. 

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Currently, most malpractice limitations run between one and three years; some research shows that regret tends to manifest about a decade after transition. Whether these bills will pass remains to be seen. Meantime, the OCR is giving gender activists in schools what might prove to be a final shot of testosterone in the arm.