The Harmful Effects of Cross-Sex Hormonal Treatment on Gender Dysphoric Youth

Last month, 20-year-old Isabelle Ayala filed a first-of-its-kind lawsuit, accusing the American Academy of Pediatrics (AAP) of civil conspiracy, fraud, and medical malpractice. Ayala claims to have been pressured by AAP-affiliated doctors into so-called “gender-affirming care” as a minor.  

Like the many young girls who were subjected to experimental gender “transition” therapies, Ayala’s story begins with significant emotional and mental distress during her adolescence. Sexually assaulted at age seven, she experienced early-onset puberty at age eight. Deeply uncomfortable in her own body, she began, at age 11, to cut herself. Around the same time, she was introduced to the concept of transgenderism through online social media platforms like Instagram, Tumblr, and Kik. At age 13, Ayala’s parents separated, and she was moved from Florida to Rhode Island. By age 14, she became convinced that she had been born in the wrong body and that “transitioning” to living as a man was the only way to solve her problems.  

Ayala’s story is tragic and, tragically, not unique. The number of young women claiming transgender identities has increased dramatically in recent years and now outnumbers the young men with gender confusion (an increase of 5,000% at the Tavistock Clinic in the U.K.). The factors driving the spike in confusion among young women include childhood trauma, social contagion, and social media, or some combination of the three.  

However, rather than treating the underlying factors and distress contributing to her dysphoria, Ayala’s pediatricians treated their effects as normal. They ignored her family’s history of anxiety disorder, bipolar disorder, PTSD, and depression, as well as Ayala’s formal diagnoses of ADHD, depression, and anxiety. Her pediatricians encouraged and facilitated her confusion with ideological blinders that treated what was, in reality, a pseudo-medical fad as if it would help a vulnerable young woman.  

Desperate to help their daughter, Ayala’s parents trusted these medical professionals who, while feigning objectivity, were, in fact, captured by gender ideology. Though her parents initially sought out interventions that were “totally reversible,” her pediatricians claimed “cross-sex hormonal treatment” was the best option and accepted treatment for her distress and gender dysphoria. In an all-too-common bit of parental manipulation, these doctors asked Ayala’s parents whether they would “prefer a dead daughter or a living son.”  

Doctors who say this are wrong. So-called “transition” treatments do not address core mental health problems, leave patients with additional, irreversible medical conditions, and fail to address the social factors driving the dramatic increase in body dysphoria among young women. Research suggests that after an initial “honeymoon” period in which patients embrace their new “identities” and harmed bodies, they remain at a disproportionate risk for serious mental illness and suicide. Chemical “transition” treatments are also not “fully reversible” as is often promised. Women who take testosterone experience irreversible masculinizing effects, such as deeper voices and facial hair, and commonly infertility.  

Still, after just a few appointments, Ayala was placed on a rapidly increasing dosage of testosterone. However, contrary to what these doctors predicted, Ayala experienced no significant decrease in depression despite an accompanying prescription of antidepressants. Within six months, Ayala was hospitalized for a panic attack. Within eight months, she was hospitalized again following a suicide attempt. With no signs that her depression was abating, her doctors prescribed higher doses of antidepressants, while continuing to inject her with cross-sex hormones.  

The following year, Ayala moved back to Florida. Initially, she continued to take testosterone. But, a year after moving, “she distanced from the control and influence” of the doctors who ushered her down this road of gender “transition.” Eventually, she quit taking cross-sex hormones and “gradually grew out of her gender dysphoria,” realizing that her distress over her identity as a female was the result of traumatic childhood experiences. Her reversal reflects the majority of adolescents who experience gender dysphoria. Research suggests that between 88% to 98% of young adults reconcile to their biological sex if allowed to go through puberty.  

Thankfully, Ayala’s story isn’t finished. If successful, this lawsuit could protect many, many minors from these horrific, experimental chemical and surgical interventions. The many medical professionals who perpetrated this harm would be held accountable and, in the future, forced to do their job helping rather than harming. Young women like Ayala need to know that their hearts, minds, and bodies can find healing from their trauma and can learn to accept who they are as a gift of God. 

This Breakpoint was co-authored by Jared Eckert. 

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