On February 27, Algemeen Dagblad, the second-most widely read newspaper in the Netherlands, published an astonishing article. Written by Berendien Teteleptal, the author reports that “more research on sex changes in young people under the age of 18 is urgently needed. Doctors who provide transgender care in Nijmegen and Amsterdam say they know too little about the target group and the long-term effects.” (See here for an English translation of the article.)
What makes this article surprising is that it was a Dutch team of researcher-clinicians (one of whom is extensively quoted in the piece) who pioneered the use of puberty blockers in children with gender dysphoria; this practice is now widespread in the western world.
Quoted in the aforementioned article by Tetelaptal, Thomas Steensma, one of the lead researcher-clinicians at the Center of Expertise on Gender Dysphoria in Amsterdam, asks some critical questions that U.S. “affirmative” clinicians largely ignore.
Because what is behind the large increase of children who have suddenly registered for transgender care since 2013? And what is the quality of life for this group long after the sex change? There is no answer to those questions. And that must happen, think Steensma and colleagues from Nijmegen.
Steensma is not alone amongst Dutch clinicians. Annelou L.C. de Vries a psychiatrist with the Department of Child and Adolescent Psychiatry at Amsterdam University Medical Centers, who, like her colleagues, has published widely on pediatric gender issues for many years. In a commentary published in the October 2020 issue of Pediatrics, de Vries writes:
According to the original Dutch protocol, one of the criteria to start puberty suppression was “a presence of gender dysphoria from early childhood on.” Prospective follow-up studies evaluating these Dutch transgender adolescents showed improved psychological functioning. However, authors of case histories and a parent-report study warrant that gender identity development is diverse, and a new developmental pathway is proposed involving youth with post puberty adolescent-onset transgender histories. These youth did not yet participate in the early evaluation studies. This raises the question whether the positive outcomes of early medical interventions also apply to adolescents who more recently present in overwhelming large numbers for transgender care, including those that come at an older age, possibly without a childhood history of GI [gender incongruence]. It also asks for caution because some case histories illustrate the complexities that may be associated with later-presenting transgender adolescents and describe that some eventually detransition.