How Convenient

Experimented on Kids, Then Forgot to Follow Up

Imagine a medical field so revolutionary, so compassionate, that it doesn’t need to follow the basic tenets of ethical practice: informed consent, long-term follow-up, and accountability. Now stop imagining—this is the reality of “gender-affirming care” for children.

Under the guise of progress, we’ve handed puberty blockers, cross-sex hormones, and surgeries to children with gender dysphoria without pausing to ask, “What happens down the road?” The answer? We don’t know, and shockingly, we don’t seem to want to find out.

Could it be that tracking the outcomes of these interventions would mean confronting uncomfortable truths—truths that could challenge the narratives and incentives propping up this industry, an industry that thrives on promises but shies away from providing hard data?

The Convenient Silence

Medicine, when practiced ethically, demands follow-up. Clinical trials require researchers to study participants for years, often decades, to assess outcomes. This is particularly true for experimental treatments.

Photo by Diana Polekhina on Unsplash

So why has gender medicine exempted itself from these standards? Consider Amy Tishelman, former research director at Boston Children’s Hospital’s Gender Multispecialty Service. She tried to initiate long-term studies to track all the kids they’d put on puberty blockers and hormones over the years, aiming to fill a glaring gap in understanding what becomes of these children years or decades down the line.

Then, in 2020, she sued the hospital for gender and age discrimination, alleging unequal pay and hostile treatment compared to male colleagues. She was fired in 2021—officially for a HIPAA violation involving patient records—but a jury ruled in 2024 that it was retaliation for her lawsuit, awarding her nearly $2 million in damages.

While it’s unclear if her push for follow-up directly caused her firing, the timing strongly suggests resistance from a system that might not welcome such accountability.

Across the Atlantic, the NHS now plans a controversial new puberty blocker study following the 2024 Cass Review, which exposed the flimsy evidence behind these drugs and led to a ban on prescribing them to minors outside research in England—a major shift in policy.

Yet Tavistock’s Gender Identity Development Service, closed in 2023 after treating over 1,000 kids with blockers, holds years of detailed outcome data that remains largely unpublished or inaccessible to independent researchers—data from real patients, real lives, spanning over a decade of interventions.

The Cass Review team, led by Dr. Hilary Cass, fully expected to analyze this mountain of records to get a clear picture of long-term effects—physical health, mental well-being, regret rates, everything. Instead, they were met with obfuscation as Tavistock shared only fragments, like early findings showing no mental health improvement, while withholding the bulk of comprehensive patient outcomes.

Former clinicians have hinted at internal reluctance, and Freedom of Information requests from journalists and academics have been stonewalled with excuses about patient privacy or administrative hurdles, leaving a massive evidence gap.

Some question why a fresh study is needed when this existing data—potentially revealing the full scope of benefits or harms—sits unused, locked away in filing cabinets or databases. The silence leaves a generation of young adults as possible evidence of harm—evidence that could dismantle the lucrative pipeline built on transitioning children.

The Lie of “Reversible” Puberty Blockers

Puberty blockers were sold as a harmless “pause button.” Advocates claimed they simply bought time for kids to decide whether transitioning was right for them.

But follow-up studies on adults who took puberty blockers in childhood are practically non-existent. And what little evidence we do have—like those initial Tavistock reports showing no psychological uplift—points to significant physical and psychological consequences that linger long after the drugs stop.

By halting puberty, they can cause permanent changes in bone density, brain development, and sexual function—changes we still don’t fully understand because no one’s tracked these kids systematically into their 20s, 30s, or beyond. These aren’t speculative concerns; they’re well-documented risks of interfering with the endocrine system, risks spelled out in medical literature but rarely in clinic waiting rooms.

And yet, we’ve blithely prescribed these drugs to children as young as eight, promising parents that their use is temporary and without consequence. Where are the studies tracking these children into adulthood? How many have gone on to regret delaying puberty, realizing only later that the decision wasn’t reversible at all? We don’t know because no one is looking.

Short-Term Thinking, But a Long-Term Problem

This failure to follow up reflects a broader issue: gender medicine’s obsession with short-term results. The studies often cited to justify these interventions focus on immediate satisfaction or mental health outcomes, typically measured within a few years—snapshots, not sagas.

Johanna Olson-Kennedy, head of Children’s Hospital Los Angeles’s youth gender clinic, led a 2015 NIH-funded study of 95 kids on blockers. Two years in, the results showed no mental health improvement—data she’s withheld by 2024, telling The New York Times she feared it’d be “weaponized” against her work, despite a 2022 paper noting 25% of her cohort had depression or suicidal thoughts at the start.

But what about a decade later, when these kids are adults living with the consequences of irreversible surgeries and lifelong medical dependence? The Cass Review in 2024 found the evidence for improved mental health outcomes from blockers is “low quality” at best, a judgment based on thin, short-term studies.

The oft-repeated claim that “gender-affirming care” prevents suicide isn’t based on rigorous, longitudinal studies—it’s based on assumptions and anecdotal evidence, weaponized to silence critics. Are these adults happy? Are they healthy? Do they regret transitioning? Have their original mental health struggles resolved, or have they worsened? Are they able to sustain relationships, careers, and fulfilling lives? Without data, we’re left guessing.

A Medical Assembly Line

Behind the failure to follow up lies an even bigger problem: the industrialization of gender medicine. What started as a treatment pathway for a small subset of gender dysphoric adults has become a one-size-fits-all approach applied to any child questioning their identity.

At Boston Children’s, Tishelman testified assessments dropped from twenty hours to four hours to two—a rushed process that churns kids through faster. The process is disturbingly mechanical: a child expresses discomfort with their gender, is immediately referred to a gender clinic, and within months—or even weeks—begins a medical transition.

Puberty blockers lead to cross-sex hormones, which often lead to surgeries. Each step locks the child further into a medicalized identity, with little room for reconsideration or pause.

This conveyor belt approach is profitable—clinics expand, pharmaceutical companies sell more drugs, surgeons book more procedures—while insurance providers and government programs foot the bill. But when those statistics become inconvenient—when they regret their transitions, experience complications, or simply stop engaging with the system—they’re forgotten, dropped from the ledger. Their stories don’t fit the narrative of empowerment and progress, so they’re ignored.

Detransitioners: The Voices We Need to Hear

The existence of detransitioners is perhaps the most damning evidence of gender medicine’s failures. These are individuals who believed the promises of “gender-affirming care,” only to realize later that transitioning didn’t resolve their struggles.

Many report feeling rushed into medical decisions without adequate counseling or information about alternatives—sometimes after those quick two-hour consults Tishelman criticized. Their stories—of regret, medical complications, and mental health struggles—deserve to be heard.

Yet there’s no systematic effort to track the number of people who detransition, let alone understand why. Olson-Kennedy’s withheld data might validate their experiences, but without it, they’re dismissed as anomalies or, worse, traitors to the cause.

Why isn’t every detransitioned person a mandatory case study? Why aren’t their experiences informing better care? The answers might point to a system afraid of what it’d find.

Who is Accountable?

Medicine is supposed to be evidence-based. When new treatments emerge, they’re rigorously tested, debated, and refined over time.

But gender medicine has short-circuited this process—it’s been fast-tracked into mainstream practice without the evidence to back it up, propelled by urgency and ideology. Tishelman’s firing, Olson-Kennedy’s delay, Tavistock’s opacity—who bears responsibility for the fallout? Doctors? Gender clinics? Pharmaceutical companies? Activists?

None of these groups seem willing to accept accountability, each pointing elsewhere while the young adults we experimented on deal with the consequences—consequences we can’t even quantify without follow-up.

A Call to Reckoning

The silence around follow-up care and long-term outcomes isn’t just a medical and scientific failure; it’s a moral one. We’ve allowed ideology and profit to dictate the care we provide to some of the most vulnerable members of society: children.

It’s not too late to demand better. We need rigorous, longitudinal studies—starting with unlocking Tavistock’s trove of patient records—to track the outcomes of medicalized gender transitions. We need to listen to detransitioners and incorporate their experiences into clinical practice.

And we need to hold the industry accountable for the harm it’s caused, harm that’s still unfolding in lives we’ve lost sight of. Because this isn’t just about the kids who’ve already been through the system—it’s about the next generation waiting in the wings.

If we don’t act now, we’ll continue sacrificing children on the altar of ideology, leaving them to pick up the pieces of a shattered adolescence. The question is simple: will we have the courage to face the truth? Or will we keep turning away, content to let the silence cover our tracks?