The Transgender Medicine Divide: Europe and the US Take Different Paths

The Transgender Medicine Divide: Europe and the US Take Different Paths

The debate on transgender medicine in youth care approaches is growing more pronounced, with Europe and the US showcasing contrasting viewpoints. While the US is progressively embracing comprehensive gender affirmation, many European nations are leaning towards a more conservative stance, emphasizing the importance of psychotherapy and minimal medical interventions.

Differing Perspectives and Research Gaps

European medical professionals have expressed reservations about certain American treatments tailored for transgender minors. In-depth reviews highlight potential gaps in research, casting shadows on a celebrated Dutch study, previously heralded as the benchmark in pediatric transgender health.

Some American studies advocating for medical interventions face increasing scrutiny. Consider a prominent study from Seattle Children’s Hospital that endorsed hormonal treatments. However, delving deeper reveals that both the treatment and control groups showcased similar positive results, hinting at other underlying factors that might influence outcomes.

Claims about minimal transition regret and the potential surge in suicide risks among transgender teens currently lack concrete backing. The real scope of transition regret remains ambiguous, and the supposed correlation between withholding medical interventions and increased suicide risks remains unproven.

Several American medical bodies, like the American Academy of Pediatrics and WPATH, have presented guidelines built on narrative reviews, which inherently carry a higher bias risk. Yet, these guidelines have gained traction in the US, leading to the rise of ‘consensus-based’ medicine. This practice has drawn the attention and concern of several entities, including the British Medical Journal.

European Prudence vs. American Approaches

In stark contrast, nations like the UK and Nordic countries, equipped with centralized healthcare frameworks, tend to rigorously assess evidence before endorsing treatments. The US’s distinctive stance in transgender youth care approaches might be influenced by factors such as profit-driven agendas, activism, and political dynamics.

While transgender medicine is still blossoming as a discipline, the evident divide between Europe and the US underscores the urgent need for evidence-centric strategies. It’s only through the diligent scrutiny of esteemed scientific publications and expert-led studies that we can anchor this pressing conversation in tangible data.


  1. Abbruzzese, E., Levine, S.B. and Mason, J.M. (2023) “The Myth of ‘Reliable Research’ in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies—and research that has followed,” Journal of Sex & Marital Therapy, pp. Available at: 
  2. Block, J. (2023) “Gender dysphoria in young people is rising—and so is professional disagreement,” BMJ, p. p382. Available at: 
  3. City Journal (2023) Yes, Europe Is Restricting “Gender-Affirming Care” | City Journal. Available at: 
  4. Expósito-Campos, P. and D’Angelo, R. (2021) “Letter to the Editor: Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence,” Plastic and Reconstructive Surgery. Global Open, 9(11), p. e3951. Available at: 

Tordoff, D.M. et al. (2022) “Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care,” JAMA, 5(2), p. e220978. Available at:

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