- [Heather] Transgenderhealthcare for kids

is a fast-growing medical specialty.

In the US, dozens of clinicspromote a single approach

known as gender affirmative treatment.

- It's just amazing how quickly

this phenomenon has kind of arisen,

and then how extensive it is.

It went from nothing to 45,

and they're at the mostelite institutions.

- [Heather] And it's catchingmany parents off guard.

- She came into the kitchen one night

when I was cooking dinner

and just told me, "Mom, I'mtransgender, I'm a boy."

- [Heather] The USProfessional Association

for Transgender Health

wrote the US Surgeon General last year,

claiming consensus amongproviders over the treatment.

But a small group of pediatricians

who specialize in hormones

are raising serious concerns.

Dr. Paul Hruz is one of them.

- We really have no longterm data

in using this intervention in children.

What we do have are short-term studies

that have very seriousweaknesses and limitations.

- [Heather] Hruz is a pediatric researcher

at the Washington UniversitySchool of Medicine

who is worried about thelongterm health of kids

who receive gender affirmative treatment.

The first step known as social affirmation

can begin as early as three years old.

- So rather than questioning somebody

who asserts a gender identity

that's not in agreement with their sex,

that one actuallysupports that individual.

- That support can include

allowing children to cross-dress,

use new pronouns,

and enter opposite-sex bathrooms.

The next step, puberty blockers,

can start as early as eight.

Advocates say they buy time for children

to think through changing their gender

and help to prevent suicide

related to distress around gender.

Dr. Hruz says that while statistics show

this might work in the short term,

there's no evidence theseblockers curb suicidal thoughts

in the long term.

- What's most concerning

is that if you look atwhat data is available

in these children that are given

this gender affirming approach,

that the suicidal ideationremains markedly elevated.

- [Heather] And he questions

whether preventing a keydevelopmental stage like puberty

is good science.

- Maybe the parallel is

if a child has a math exam next week

and you tell them thatthey don't need to take it,

that's gonna relieve theiranxiety about the test,

but have you really helped that child?

- [Heather] If a child persists

in questioning their gender identity,

this gender affirmative treatment

calls for prescribing cross-sex hormones

and even surgery when children reach 18.

But studies like thisone show that, in fact,

surgeons are performingdouble mastectomies

on teenage girls.

The combined whammy of puberty blockers

plus cross-sex hormones

can take a huge hit on adolescent bodies,

starting with infertility.

- It's expected that the outcome is

to result in lifelong sterility,

so you're taking away a child's fertility

at an age when they reallydon't have an understanding

of what they're giving up.

- [Heather] There'salso research that shows

increased risk of strokeand metabolic changes

that can lead to heart attacks,

diabetes and weakened bones.

- Puberty is a very important time

for acquiring bone density,

and that if that is interrupted,

the children are gonna beat risk of osteoporosis

and fractures later in life.

And the question thatneeds to be asked is,

if this turns out notto be a good approach,

how many children are going to be harmed?

- Unbelievably, thesemedical interventions

could be totally unnecessary.

Even the World Professional Association

of Transgender Healthcare

acknowledges research showing

that most children with gender issues

will outgrow it before adolescence.

Just last month,

the United Kingdom'sNational Health Service

quietly changed its guidanceon these interventions.

"Little is known aboutthe long-term side effects

"of hormone or pubertyblockers in children.

"It is not known what thepsychological effects may be.

"It's also not knownwhether hormone blockers

"affect the developmentof the teenage brain

"or children's bones."

The action may have beenfueled by the protests

at a London transgender clinic.

As The Telegraph reports,

35 staff have resignedin the last three years,

concerned about over-diagnosisof gender dysphoria in kids.

Dr. Hruz acknowledges the tough road

that parents of childrenstruggling with their gender face.

He encourages them to support their kids

and be cautious aboutthe affirmative approach.

They can also consider counseling

to understand psychologicalfactors that may be present,

or a wait-and-see approach,

knowing that their childmay outgrow their distress.

- Parents often understand,

they're looking at the bestinterest of their children,

they know their children,they love their children,

and they don't wanna doanything to harm their children.

Parents being educatedabout what is really known

and what is not known about this condition

and what the alternatives are

I think can help them inmaking those decisions.

- [Heather] Decisions thatcan influence their child

for a lifetime.

Heather Sells, CBN News.