Earlier this month, the Supreme Court upheld Tennessee’s ban on pediatric gender medicine, creating a precedent that could influence 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 welcomed the ruling  not out of hostility toward trans people, but as psychology researchers deeply concerned about how ideology has increasingly supplanted evidence in mental health care.

To us, the decision offers a crucial opportunity to reexamine a clinical orthodoxy that has taken hold in our field. Seizing that opportunity, however, demands that academia confront its own entrenched dogmas something Northwestern has so far shown little willingness to do.

Over the past decade, there’s been a sharp rise in gender dysphoria among adolescent girls, coinciding with a transformation in the therapist’s role. Clinicians are now often expected to affirm patients’ gender identities without exploring underlying factors. In the rush to validate, practitioners sometimes overlook alternative explanations for gender distress.

For example, sexual trauma can lead to bodily alienation, numbness, and disgust  symptoms that can easily be mistaken for gender dysphoria. Branding such caution as “transphobia” risks diverting traumatized girls away from appropriate care and toward irreversible interventions of the kind addressed in Skrmetti.

There are many reasons adolescent girls might reject their bodies unrelated to the concept of “gender identity” as defined by activists. Today’s young women grow up in a hypersexualized culture that commodifies their bodies and damages self-esteem. In our coursework at Northwestern, we were shown a video series that defined “trans” as anyone deviating from gender expectations tied to their “sex assigned at birth.” But when those expectations are shaped by misogyny and a culture that eroticizes female suffering, it’s not surprising that some girls seek to escape womanhood by suppressing puberty or undergoing double mastectomies.

Mental health professionals have historically misunderstood female trauma. Borderline personality disorder, for instance, is disproportionately diagnosed in women  especially those who are survivors of sexual abuse. Many detransitioners report similar dynamics. Young women like Prisha Mosley, Chloe Cole, Luka Hein, and Isabelle Ayala have publicly connected their dysphoria to trauma. Simon Amaya Price, a fellow at Do No Harm, told us he hasn’t met a single detransitioner whose gender distress wasn’t trauma-related. While anecdotal, his view reflects a growing body of cases where clinicians bypass trauma treatment and refer patients directly for life-altering gender interventions.

Other countries are already grappling with these concerns. Well before Skrmetti, several European nations restricted pediatric gender medicine to clinical trials, citing poor evidence and significant risks. This pivot was largely driven by the Cass Review  a comprehensive, independent inquiry revealing major flaws in the research base and recommending psychotherapy, rather than hormones or surgery, as the first-line treatment.

The Cass Review poses a significant challenge to U.S. institutions that continue to champion the gender-affirming model. Many American organizations have dismissed the report, but some of the strongest defenders  like the American Academy of Pediatrics  now face lawsuits from detransitioners. They are in a bind: acknowledging the Cass Review’s findings could expose them to legal liability.

Even the World Professional Association for Transgender Health (WPATH), whose Standards of Care influence policy worldwide, is under scrutiny. Whistleblowers and court documents have revealed that WPATH suppressed unfavorable data, lowered age minimums for gender surgeries under political pressure, and endorsed treatments that even some of its own members admit are poorly researched and potentially harmful.

Unfortunately, Northwestern continues to uphold the credibility of these compromised organizations, treating the gender-affirming model as settled science. The university projects a façade of expert consensus while endorsing experimental practices  and its affiliated hospital profits from gender procedures through the Gender Pathways program, raising significant questions about conflicts of interest.

If patient safety alone isn’t enough to spur introspection, Northwestern’s obligations as a research institution should be. Yet in our experience, critical inquiry is actively stifled. Students have been prohibited from citing the Cass Review, with some faculty dismissing it as “debunked,” despite its central role in informing the Supreme Court’s decision.

As scrutiny increases, so too does censorship. When we submitted an op-ed to The Daily Northwestern outlining these concerns, it was rejected without explanation. Days later, the paper changed its editorial policy: all submissions would henceforth be reviewed under the Trans Journalists Association Style Guide, which bans 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 discussions. Banning them in student journalism signals the rise of a gender-newspeak aimed at silencing dissent by making it linguistically unspeakable. This contradicts the academic integrity Northwestern claims to value  a moral hypocrisy akin to reciting a land acknowledgment while counting cards at a tribal casino.

Given Northwestern’s institutional and financial investment in gender-affirming care, it’s unlikely the university will self-correct. Yet the Skrmetti decision changes the landscape.

This ruling legitimizes the voices of clinicians, researchers, and detransitioners who have long been silenced by fear and intimidation. It may finally encourage others to speak out  to protect vulnerable young people and to restore intellectual honesty to institutions that have lost their way amid our ongoing culture wars.

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