An Olive Branch

An Open Letter to LGBTQ Organizations

An Open Letter to LGBTQ Organizations
From Lauren Leggieri and Jamie Reed

A note to our readers:

We are publishing this as an open letter and explicitly invite you to share it with LGBTQ organizations and leaders in your local communities—especially those providing guidance to families and youth. If you are comfortable doing so, you may also share the names or direct contact information for local LGBTQ organizations in the comments. We will reach out ourselves and extend this invitation to talk, off the record and in good faith.

A Week That Changed the Landscape

In the span of a single week, three developments—legal and medical—landed almost back to back. Taken together, they mark a turning point that LGBTQ organizations should not ignore.

These events occurred while we were traveling across the country, testifying and speaking in multiple states on issues related to pediatric gender medicine and the medicalization of gender nonconformity. In every place we went, we did the same thing we always do: we reached out to local LGBTQ organizations, offered coffee, off-the-record conversations, and a simple message—We are open to dialogue.

What follows is why we are extending that invitation again, now.

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First: A Jury Verdict

For the first time in the United States, a jury found medical providers liable for harms arising from pediatric gender surgery.

A young woman who underwent a double mastectomy at age sixteen—and later detransitioned—won a malpractice verdict against the clinicians involved in her care. The jury concluded that standards of care were not met and awarded damages reflecting not only past harm, but lifelong medical consequences.

This was not a political ruling. It was a decision made by ordinary citizens weighing expert testimony, medical records, and the reality of irreversible medical intervention on a minor.

Whatever one believes about gender medicine in theory, this verdict establishes something new in practice: courts are now willing to scrutinize these interventions as medicine.

As people who worked inside this system, we know that the care at issue in this case closely resembles the standard of care used in many pediatric gender clinics across the United States over the past decade. This ruling is unlikely to be the last.

Second: Plastic Surgeons Reversed Course

Within days of that verdict, the American Society of Plastic Surgeons (ASPS) —representing more than 11,000 surgeons—issued new guidance.

Their conclusion was stark: there is insufficient evidence to support gender-related surgical interventions on minors, and they recommended that such surgeries be delayed until at least age nineteen. Notably, the ASPS statement also raises concerns about the efficacy of puberty blockers and cross-sex hormones.

For years, supporters of pediatric transition have insisted that medical consensus was settled. That claim is no longer sustainable when the largest professional body responsible for these surgeries states plainly that the evidence does not justify them in children.

The surgeons framed this explicitly as an evidence problem—limited data, weak long-term outcomes, and irreversible physical consequences for developing bodies.

Third: A Broader Institutional Shift

Shortly afterward, the American Medical Association publicly aligned with these concerns, acknowledging that the evidence base does not support surgical gender interventions in minors and that such procedures should generally be deferred.

This matters not because any institution is infallible, but because it represents a shift away from categorical certainty and toward acknowledged medical uncertainty—after years in which uncertainty was denied.

When juries, surgeons, and national medical bodies all move in the same direction within a single week, responsible leadership requires a pause.

That pause is what this letter is asking for.

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What This Means for LGBTQ Organizations

Many LGBTQ organizations acted in good faith. Many believed they were protecting vulnerable youth from stigma, despair, and suicide. Many relied on professional associations that assured them the medicine was settled.

But leadership now requires more than affirmation. It requires adjustment when facts change.

Across the country, parents and young people are encountering:

• Clinics that are closing or quietly restructuring

• Clinicians revising guidance

• Lawsuits that are no longer hypothetical

• Medical bodies acknowledging uncertainty that was previously denied

Families are not asking for slogans. They are asking, What do we do now?

If your organization has not yet had serious internal conversations—at the board level, among staff, or with clinicians—the time is now. You do not have to do that work alone. We are offering to help.

Continuing to provide information as if nothing has changed risks real harm—not only to children’s bodies, but to the trust LGBTQ organizations hold within their communities.

We are not asking you to recant your values.
We are not asking you to surrender to politics.

We are asking you to pause and start helping families navigate reality as it is.

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How We Are Offering to Engage

When we say we are open to dialogue, we mean something specific and practical.

We are offering off-the-record conversations with LGBTQ organizational leadership—board members, executive staff, or program directors—focused on what has changed, what families are encountering now, and how organizations can respond responsibly.

We can provide:

• Briefings on recent legal, medical, and institutional developments

• Context from inside pediatric gender clinics and advocacy systems

• Practical guidance on harm-reduction approaches for families

• Space for candid questions, concerns, and disagreement without public pressure

These conversations are not recorded, not performative, and not meant to produce immediate public statements. They are meant to help leaders think clearly in a moment of real change.

Organizations or leaders who wish to talk can contact us at:

lgbcouragecoalition@gmail.com

We are open to meeting virtually or in person, depending on what is most useful.

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An Olive Branch, in Practice

Even if you remain fully supportive of pediatric medical transition, we are asking—urging—you to consider at least the following harm-reduction steps for families in your communities.

Leadership means preparing people not only for best-case outcomes, but for real ones.

Start with records and truth

Encourage parents to obtain complete medical records now—full records, not summaries or portals—especially as clinics close or merge. Children grow up. They ask questions. They deserve answers grounded in documentation, not memory.

Organizations can help by teaching families how to request records, organize them, preserve them, and add to them over time.

Establish physical baselines

If a child has ever been placed on puberty blockers, parents should be advised to request bone-density scans and full metabolic and endocrine labs. This is not alarmism. It is basic medicine.

Encourage families to establish care with primary physicians outside gender clinics and to focus on sleep, nutrition, exercise, and overall health.

Do not evade fertility

If fertility preservation did not occur, patients deserve real consultations with specialists—not reassurance, deferral, or dismissal.

A thirteen-year-old may not care about fertility. A thirty-year-old almost certainly will. LGBTQ leadership should acknowledge this reality and help families access honest information and appropriate referrals.

Normalize slowing down

Make real room for exploratory psychological support—therapy that asks why a child is distressed, not only how quickly medicine can respond.

Slowing down is not denial.
It is care.

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A Note on Organizational Culture

This moment also calls for internal openness.

As leaders, it is worth asking whether staff, volunteers, and board members are able to discuss emerging evidence, uncertainty, and alternative forms of support without fear of being shut down, labeled, or disciplined.

We are not asking organizations to abandon their values. We are asking whether there is room—now—for honest internal conversations that reflect the reality that the evidence base itself is shifting.

Leadership does not mean having every answer. It means being willing to ask harder questions together.

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For Families Who Are Now Unsure

Some parents are realizing, quietly and painfully, that the certainty they were promised no longer exists.

They should not be shamed.
They should not be isolated.
They should not be told that asking questions is betrayal.

If a child pauses or stops medical intervention, they deserve structured medical follow-up and emotional support—not abandonment.

No family should be left adrift because the narrative changed faster than they could keep up.

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Why We Are Extending This Olive Branch

We are not outsiders to this issue.

We are gay and lesbian adults who understand gender nonconformity, social pressure, medical authority, and what it means to grow up misunderstood. Many gender-nonconforming children grow up to be ordinary gay adults. We know this because we are them.

When we say we care about gender-nonconforming kids, this is what we mean:

• Their physical health

• Their mental health

• Their future autonomy

• Their families

The evidence has shifted. The risks are clearer. The cost of pretending otherwise is now too high.

We do not have to keep doing this the way we have been.

Dialogue is still possible.
But only if honesty comes first.

If you are an LGBTQ organizational leader reading this because someone in your community shared it with you, we invite you to pause and consider reaching out. Even a single conversation can help clarify what support looks like now—when certainty has fractured and families are asking for guidance, not slogans.

Our door is open.
And the kettle is still hot.

Lauren Leggieri
Jamie Reed