
I am worried about the growing number of young children who are being assisted to transition to the opposite sex. I feel we should be counselling these children rather than assisting them to transition. Do you have any thoughts on this?
The situation you describe is growing, especially in recent years. In years gone by the number of transgender people was less than one percent of the population but now, among 16-25 year-olds, it has risen to several per cent. As you say, there is a widespread effort to assist these children, first by giving them puberty blockers, then cross-sex hormones and finally, if they want it, surgery.
There are dangers in this. First, children, especially in primary school, are not old enough to make decisions which will so radically affect their future well-being. They are only children, after all. We find evidence of this in the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association, which reports that as many as 98 per cent of gender-confused boys and 88 per cent of girls will accept their biological sex by late adolescence.
Second, a report by the American College of Pediatricians in June 2017 says that the harmful effects of taking cross-sex hormones (testosterone for girls and oestrogen for boys) and sex reassignment surgery can be severe. The rate of suicide in Swedish adults who used these means was nearly 20 times higher than in the rest of the population, and 62 per cent of male-to female transgender persons and 55 per cent of female-to-male persons suffered from depression, much higher than in the rest of the population. A US survey conducted by the National Gay and Lesbian Task Force and National Centre for Transgender Equality found that 41 per cent of transgender persons had attempted suicide, compared with 4.6 per cent in the overall population.

Third, pre-pubescent children with gender dysphoria will often be given puberty blockers and they will require cross-sex hormones in later adolescence to continue to live in accordance with the opposite sex. As a result, they may become sterile and never able to conceive any genetically-related children, even via artificial reproductive technology. Moreover, cross-sex hormones have such health risks as cardiac disease, high blood pressure, blood clots, stroke, diabetes and cancer.
As a result of these issues, there has been a growing push for a much more cautionary approach in some countries. The United Kingdom’s National Health Service (NHS) recently warned doctors not to encourage children who believe they are transgender to change their names and pronouns, finding that most of them are only going through a “phase.” Significantly, the NHS announced that the UK’s Tavistock gender identity clinic, where most of the gender reassignment therapy was conducted, would be shut down early in 2023, following a review which found staff felt under pressure to adopt an unquestioning affirmative approach.
In February 2022, the French National Academy of Medicine warned that “great medical caution must be taken in children and adolescents, given the vulnerability, particularly psychological, of this population and the many undesirable effects, and even serious complications, that some of the available therapies can cause.” Similar concerns were raised by Sweden’s National Board of Health and Welfare in February 2022, after a review found “the evidence base for hormonal interventions for gender-dysphoric youth is of low quality, and … hormonal treatments may carry risks.”
More recently, in December 2024 the UK’s Department of Health and Social Care (DHSC) announced a permanent ban on children receiving puberty-blocking drugs to facilitate gender transition. The decision was based on independent expert advice from the Commission on Human Medicines which determined that “there is currently an unacceptable safety risk.”
In both the UK and the US there have been lawsuits brought by people who had been assisted to transition in gender and later found the effects to have been profoundly damaging.