The evidence to support medicalised gender transitions in adolescents is worryingly weak

Many of today’s patients say they began to suffer from dysphoria as teenagers. The Dutch protocol excludes those with mental- health problems from receiving treatment. But 70% or more of the young people seeking treatment suffer from mental-health problems, according to three recent papers looking at patients in America, Australia and Finland.

Despite the protocol’s caution, says Will Malone of the Society for Evidence-Based Gender Medicine, an international group of concerned clinicians, the reality is often the reverse, especially in America, with mental-health issues becoming a reason to proceed with transitions, rather than to stop them.