SEGM Bulletpoints The Madness

The Society for Evidence-Based Gender Medicine (SEGM)1 An international group of over 100 clinicians and researchers concerned about the lack of quality evidence for the use of hormonal and surgical interventions as first-line treatment for young people with gender dysphoria. They represent expertise from a range of clinical disciplines. was mentioned in my last two posts. They have done a great job accumulating the relevant studies from which today’s Gender Science is based. If you enjoy reading technical scientific abstracts and journal articles, and who doesn’t <grin>, you will find your fill at their website.

But for now let’s just focus on their home page Bullet Points which outline the single Dutch study upon which today’s Gender Affirming Care Model of hormones and radical surgery is based.

A single Dutch study!

  • 55 subjects (only 40 with complete data)
  • 100% had childhood-onset gender dysphoria (no adolescent-onset gender dysphoria cases which are the vast majority of cases today)
  • Only 1.5 year post-surgery follow-up at an average age of under 21
  • No control group
  • No physical health effects evaluation
  • One adolescent died as a result of post-operative complications. Several others could not pursue treatment due to new health issues arising following hormonal administration.
  • Unchanged or worsening gender dysphoria and body image difficulties while on puberty blockers, especially among natal adolescent females.

Multiple subsequent studies have found the following associations with the “standard care” treatments:

  • Bone/skeletal impairments
  • Cardiovascular complications
  • Premature death
  • High rates of post-surgery suicide

Despite the uncertainties and poor evidence, hormonal and surgical interventions are being scaled up. They go beyond the experimental “Dutch protocol” by:

  • Encouraging early social transition, explicitly discouraged by the Dutch protocol
  • Being applied to young people with adolescent-onset gender dysphoria, a population not included in the Dutch study.


This past May the Karolinska Hospital in Sweden, home of the Nobel Prize in Medicine, rejected the so-called Dutch protocol. [See story here]

And yet in North America trans-advocates are shouting “full-steam ahead” on prescribing radical experimental treatments for children and teens with gender-dysphoria. All on the basis of seriously incomplete scientific research. If you say slow down, you are suspected of being a bigot interested only in so-called “conversion therapy.

This is madness.

And some in Europe, like the Swedes above, may be finally coming to their senses.

One of the lead researcher-clinicians at the Center of Expertise on Gender Dysphoria in Amsterdam, Thomas Steensma, is asking some critical questions today. On Feb 27 Algemeen Dagblad, the second-most widely read newspaper in the Netherlands published an astonishing article. Here are some excerpts:

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, thinks Steensma and colleagues from Nijmegen.

Thomas Steensma

"We don't know whether studies we have done in the past can still be applied to this time.  Many more children are registering, and also a different type," says Steensma.  "Suddenly there are many more girls applying who feel like a boy.  While the ratio was the same in 2013, now three times as many children who were born as girls register, compared to children who were born as boys."

[About the effect of early medical intervention on future fertility Steensma has this to say]

It is still unclear whether these administered hormones affect the fertility of boys and girls.  "We just don't know," says Steensma.  "Little research has been done so far on treatment with puberty blockers and hormones in young people.  That is why it is also seen as experimental.  We are one of the few countries in the world that conducts ongoing research about this.  In the United Kingdom, for example, only now, for the first time in all these years, a study of a small group of transgender people has been published.  This makes it so difficult, almost all research comes from ourselves."  

[Lamenting the lack of research, and decrying the fact that other practitioners are applying Dutch research without adequate assessment of their patients he says]

"We conduct structural research in The Netherlands.  But the rest of the world is blindly adopting our research.  While every doctor or psychologist who engages in transgender health care should feel the obligation to do a proper assessment before and after intervention."

You can read the full article here:

How can we justify a full-steam ahead mentality when the Dutch clinicians who do “almost all research” on these questions say stop “blindly adopting our research.”

Stop the Madness!


If you’ve just found my blog and are intrigued about this issue, and want to learn more, I highly recommend the book by Abigail Shrier.

Shrier is a graduate of Columbia College who went on to earn a bachelor of philosophy degree from the University of Oxford and a JD from Yale Law School.  Her book Irreversible Damage: The Transgender Craze Seducing Our Daughters was named a “best book” by The Economist and The Times of London. [2020, 2021]