Earlier this month, the Supreme Court upheld Tennessee’s ban on pediatric gender medicine, establishing a precedent for similar laws across the country. At universities like ours, U.S. v. Skrmetti was widely portrayed as a victory for far-right extremism at the expense of vulnerable transgender youth. Yet some of us at Northwestern viewed the ruling differently—not as anti-trans activists, but as psychology researchers concerned about the extent to which ideology has overshadowed evidence in mental health care.

For us, the decision offers an important chance to reexamine a clinical dogma that has taken hold of our field. But to seize this moment, academia must first confront its own deeply rooted orthodoxies—something Northwestern, so far, has shown little willingness to do.

Over the past decade, rates of gender dysphoria have risen sharply among adolescent girls, alongside a transformation in the therapist’s role. Clinicians are now expected to affirm a client’s stated gender identity, often at the expense of exploring deeper, underlying issues. In the rush to validate, alternative explanations for gender-related distress are too often overlooked.

Sexual trauma, for example, can lead to feelings of bodily alienation, numbness, and disgust — symptoms that can easily be misinterpreted as dysphoria. When caution is dismissed as “transphobia,” traumatized girls are steered away from appropriate care and toward the very kind of irreversible interventions addressed by the Supreme Court in Skrmetti.

There are clear reasons young women may reject their bodies that have nothing to do with “gender identity” as defined by activists. Adolescent girls today navigate a pornified culture that commodifies their sexuality and undermines self-worth. In coursework at Northwestern, we were shown a video series defining “trans” as anyone who deviates from gender expectations for their “sex assigned at birth.” But when those expectations are shaped by a misogynistic ethos that eroticizes female pain, it’s no surprise some girls try to escape womanhood by suppressing puberty or undergoing double mastectomies.

The field of mental health has long misread female trauma. Borderline personality disorder, for instance, is disproportionately assigned to women — especially survivors of sexual abuse. Many detransitioners describe a similar pattern. Young women like Prisha Mosley, Chloe Cole, Luka Hein, and Isabelle Ayala have publicly linked their dysphoria to trauma. Simon Amaya Price, a fellow at Do No Harm, told us he hasn’t encountered a single detransitioner whose gender distress had not been trauma-related. While anecdotal, his observation reflects a growing number of cases in which clinicians simply bypass trauma treatment and refer patients directly for life-altering gender procedures.

These concerns are being taken seriously in other countries. Long before Skrmetti, several European countries had restricted pediatric gender medicine to clinical trials due to poor evidence and high risk. This shift was driven in part by the Cass Review, a sweeping independent investigation that found major flaws in the research base and recommended psychotherapy — not hormones or surgery — as the first-line treatment.

The Cass Review poses a serious challenge to U.S. institutions that still champion the gender-affirming model. Many have dismissed the report, but some of the loudest defenders — such as the American Academy of Pediatrics — now face lawsuits from detransitioners. They are therefore conflicted, as acknowledging the Cass Review’s findings could expose them to liability.

Even the World Professional Association for Transgender Health, whose Standards of Care shape global policy, is now under fire. Whistleblowers and court filings reveal that the organization suppressed unfavorable data, dropped age minimums for gender-related surgeries under political pressure, and endorsed treatments its own members concede are inadequately studied and potentially harmful.

Unfortunately, Northwestern continues to uphold the credibility of such compromised stakeholders, presenting the gender-affirming model as settled science. The university constructs an illusion of expert consensus while promoting experimental practices — and its affiliated hospital profits from gender procedures through the Gender Pathways program, raising questions about conflict of interest.

If patient safety isn’t enough to prompt reflection, Northwestern’s responsibilities as a research university should be. Yet in our experience, critical inquiry is actively discouraged. Students have even been barred from citing the Cass Review, which is dismissed by some faculty as “debunked,” despite its central role in a Supreme Court decision.

As scrutiny grows, so does censorship. When we submitted an op-ed to The Daily Northwestern expressing these concerns, it was rejected without explanation. Days later, the paper revised its policy: All submissions would be reviewed using the Trans Journalists Association Style Guide — a document that prohibits terms like “biological sex,” “detransitioner,” “trans-identified,” and “gender ideology.”

These are not fringe terms. They appear in academic journals, medical literature, and public policy. Their ban in student journalism signals the rise of a gender-newspeak that punishes dissent by attempting to render it unspeakable. This betrays the academic integrity Northwestern claims to uphold — a moral hypocrisy akin to reciting a land acknowledgment while counting cards at a tribal casino.

Source: https://thehill.com/opinion/healthcare/5390101-gender-medicine-after-skrmetti-a-call-for-accountability-at-northwestern/