A June 25 presentation at the University of Oklahoma Health Sciences Center (OUHSC) provides further evidence that another controversial topic is making its way into the medical and cultural mainstream.

Yesterday’s “sex-change operations” are today’s “gender reassignment surgery”—while hormones and puberty blockers have become known collectively as “gender-affirming care.”

This new care model should also include the careful use of the patient’s preferred pronouns, as a means of relaxing the patient, building trust, and preventing suicide, according to two OUHSC professors. Assistant professor of pediatrics Shauna Lawlis, M.D., and assistant professor of family practice Shawn Fitzgerald, D.O., delivered their message during a special Pride Month student presentation on “Queer Healthcare.”

How ‘Gender-Affirming’ Care Works

The OUHSC presentation provided an overview of the standard medical treatments offered to patients who want to transition to the opposite gender, including both reversible and irreversible interventions.

These interventions include regular health screenings for sexually transmitted diseases, vaccinations against HPV and hepatitis, and prescriptions of estrogen- or testosterone-based hormones to change bodily characteristics like breast growth, muscle mass, skin texture, and fat distribution. GnRH, or gonadotropin-releasing hormones, are typically given to children in the 9-to-11-year-old range. Known as “puberty blockers,” they do just that. There are also non-medical interventions, including breast binders and penile prosthetics, designed to emulate a gender transition without any physically permanent changes.

The OUHSC presenters acknowledged briefly that gender dysphoria is still categorized as a mental disorder under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). They did not, however, include a discussion of counseling and mental health-related options for this patient group.

Across the United States today there is a controversial push among some LGBTQ advocates, physicians, and even parents to provide irreversible options—notably puberty-blocking hormones and sex-change surgery—to very young children and adolescents. While the OUHSC medical professionals said they did not approve of using puberty blockers or other hormonal treatment for young children and teens, they did note in their PowerPoint presentation that “Once members of the team, including patient, parents, and mental health provider(s) are on board, we can discuss more permanent interventions.” No age minimum for providing such hormones or surgical alternatives was given during the presentation, and the doctors did not take questions afterward.

Receiving special emphasis during the presentation was the issue of pronouns, which are currently a hot-button issue in the LGBTQ and broader communities. Per the doctors’ presentation, “Calling pronouns ‘preferred’ implies choice, when in reality this is not a choice. Respect a person’s pronouns, even if they are not present. If you make a mistake, apologize, correct yourself, and move on! Using their correct pronoun is suicide prevention.”

The doctors also cited The Trevor Project, which states that untreated transgender individuals have a 41% suicide-attempt rate, and that using an individual’s preferred pronouns reduces their suicide rate by half. The Trevor Project is a nonprofit organization focused on suicide prevention within the LGBTQ community. Its conclusions are disputed among medical professionals and other researchers.

“About 25% of prepubertal children diagnosed with gender identity disorder (GID), or what we now term as ‘gender dysphoria,’ will continue to meet criteria for GID well into adulthood,” Dr. Lawlis said. “In order to initiate treatment, we are looking for patients to be persistent, insistent, and consistent.”

The epidemiology of the transgender population is difficult to assess, but it’s estimated that fewer than 1% of adults and about 1.5% of adolescents identify as transgender or gender non-conforming, and the number of patients accessing care is increasingly annually, the doctors said.

Does It Really Work?

The OUHSC presentation was strictly confined to medical care, and did not cover any studies pertaining to the overall success rate of gender-affirming care. Studies are inconsistent, and the presentation did not include information as to the long-term mental and physical impacts, which are the subject of hot debate among healthcare and other experts.

In September 2020, The American Journal of Psychiatry issued a major correction to a widely-quoted Swedish study of 9.7 million individuals, after re-analysis of the data showed that transgender surgery does not, after all, lessen the need for mental health care, nor does it lower the suicide rate.

In addition, Heritage Foundation scholar Ryan T. Anderson pointed out, the study showed that patients who had sex-reassignment surgery were significantly more likely, not less, to require treatment for anxiety disorders, and that there were no mental health benefits derived from hormonal interventions. Suicide rates also remained roughly six times higher than that of the general population.

Walt Heyer, a former transgender who now runs the website Sex Change Regret, agreed, adding that teachers, healthcare professionals, and even parents are harming, not helping, young children and adolescents by pushing them to adopt gender roles and/or providing irreversible treatments.

“They keep rebranding the gender change process,” Heyer said. “First it was ‘sex change,’ then it was ‘gender reassignment.’ They want to make this not look like the child abuse it really is and now want to sell you and everyone else that it’s ‘gender-affirming’ medical care. This liberal obsession is destroying an entire generation, and they don’t care.”

Oklahoman and former transgender Laura Perry also strongly opposes the push to normalize “gender-affirming” care in children. Perry experienced a troubled relationship with her mother, plus early molestation which caused anger and confusion. Those emotions morphed into a rejection of her femininity and the conviction that she needed to live her life as a man instead of a woman. She would go on to undergo surgery and hormone therapy and presented herself to the world as “Jake” for nearly a decade.

It was only after she converted to Christianity and began following the teachings of Jesus Christ, Perry said, that she began the long journey toward resolving the true issues she needed to confront. After years of hormones, surgeries, and legal and lifestyle changes, Perry said she felt “empty and broken” and was devastated that the external changes had not given her peace of mind.

“Instead, I lived in a world of lies, suspended in limbo between reality and fantasy. I wanted to erase the existence of Laura so badly that even after realizing I could not be a man, I decided to hide and pretend, rather than embracing myself,” she added. “I often described myself before ‘coming out’ as having been wearing a mask of female identity, but just three years or so later, it was my transgender identity that had become the mask. What had promised to be freedom had, in fact, become my prison cell.”

However well-intentioned, “the affirmation that trans people desire in the form of using their proper name and pronouns is the opposite of what they need,” Perry said. “While it does seem to help in the short term, because it helps them escape the pain of their life, it never resolves any issue and only strengthens the delusion. It’s not much different than taking heroin or cocaine to numb the pain of life. While it can seem to be a good solution, it’s actually destroying them. There are thousands upon thousands of people de-transitioning, and most will say the same thing—it was never real and it never resolved the internal struggle.

“Those that are embracing the LGBTQ agenda are falling victim to a cult mentality,” she added. “It is corrupting and confusing our children before they are even able to understand. It appears to give people endless choices, but it is actually only one choice—to be in the club.”

Today, Perry said she is happy with her life, secure in her identity as a woman. She says her mental health is better than it has ever been, thanks to her faith in Jesus Christ and the support of her family.

“There are many who are de-transitioning and returning to lesbian or gay identities, but that is still ultimately unhelpful,” she said. “It’s like when doctors keep treating a mysterious disease and trying new therapies and running new tests and nothing helps, until they realize the person’s caretaker was poisoning them. Transgenderism is not the root of the problem, it is the fruit of a much bigger problem steeped in resentment and bitterness, rejection, self-hatred and, ultimately, a rejection of God.”

Oklahoma Lawmakers Protecting Kids

To push back against hormonal and surgical treatment in children, lawmakers nationwide have proposed approximately 114 bills related to transgender issues as of June 2, according to the activist organization Gay & Lesbian Alliance Against Defamation.

In Oklahoma, Senate Bill 676 was introduced in early 2021 by Sen. Warren Hamilton, R-McCurtain, as a means to protect children against the potentially devastating effects of gender-affirming care before they are old enough to determine for themselves. Co-authored by Sen. Shane Jett, R-Shawnee, and Sen. David Bullard, R-Durant, the bill specifically prevents minors from receiving puberty blockers and/or hormone therapy, even if sought by their parent or legal guardian. It prevents anyone from undergoing gender-reassignment surgical procedures before age 21, and it also imposes penalties for healthcare professionals who intentionally perform such procedures on underage patients, with or without parental consent.

The bill stalled in the Oklahoma Legislature, but will be reintroduced during the 2022 session, Hamilton said.

“It’s ridiculous—a 20-year-old can’t buy a beer or cigarettes, but they can get permanent genital mutilation to their body?” he said. “I don’t think we should be doing gender-reassignment surgery at all, but especially to children. If someone is going through mental anguish, they need some help, but this is not surgery like fixing a club foot. This is offering somebody an erroneous perception of reality. There’s all kinds of evidence from doctors who specialize in transgender care, former transgenders and others who regret their action, but that information is suppressed by the mainstream media.

“Truth is truth. Allowing underage children to permanently alter their physiology as a child, and affirming to these kids that reality isn’t reality, is wrong—and it is a rush to failure,” he added. “By doing so, we’re hurting these kids for the rest of their life, and somebody in the room has to be the adult and say ‘this is not good for you.’”

Perry is a strong supporter of the bill.

“I support any legislation that protects children and youth from making the same horrible mistake I did,” she said. “Hormones and surgeries never resolved the deep, inner conflicts in my soul. These therapies are the opposite of what they need. What they need is good counseling to resolve the emotional, and sometimes physical, wounds that have led to them rejecting themselves.”