Thank you Sharon for the opportunity to look back at the conversation we had on the Skrmetti case. It was interesting to see conservative Supreme Court justices pointing to European countries as a model for how the United States should approach transgender medical care. These same justices rarely look to European models for other healthcare policy, gun safety measures, or social programs, but just because some European countries have grown more cautious about transgender youth care, suddenly international precedent becomes relevant. Very interesting.
However, the reality is more complex than a simple rejection of gender-affirming care. While some European countries have called for more individualized assessment protocols, most have not implemented blanket bans like Tennessee's law. There are ongoing methodological debates about evidence standards, as there should be, rather than a wholesale abandonment of care.
This is fundamentally a case where parents and doctors are better positioned than government officials to make individualized medical decisions, yet we see those who typically oppose government interference making exceptions when it comes to transgender youth. Why are “parents’ rights” crusaders so quick to abandon their principles here?
The main study that gets cited in these debates is the Cass Review. Critics of trans healthcare often claim it proves all gender-affirming care is dangerous, but this misrepresents its actual conclusions if you actually read it. The Review found no proof of danger, and only concluded that there’s insufficient evidence to make definitive conclusions about puberty blockers' impact on gender dysphoria and mental health, while acknowledging some concerns about bone health during treatment.
However, the Review's methodology has been extensively criticized by international experts. It applied randomized controlled trial standards so strict that it excluded 98% of existing studies as insufficient quality, despite puberty blockers being well-established as safe and reversible for other medical uses like precocious puberty. Why would it suddenly become dangerous for people who need it for a different reason? Multiple international medical organizations have pointed to the Review's selective and inconsistent use of evidence, noting that recommendations often do not follow from the data presented. The Review also notably failed to include transgender people in its planning and decision-making process, and several people involved had previously advocated for bans on gender-affirming care. It would be like only trusting science from the tobacco industry about the effects of smoking.
Meanwhile, we have growing scientific evidence that gender-affirming care provides significant mental health benefits for transgender youth. While individual studies have limitations (such as relatively small sample sizes and shorter follow-up periods) the evidence consistently points in the same direction across multiple research efforts. A 2022 study published in JAMA Network Open followed 104 transgender youth over 12 months and found that those who received puberty blockers or gender-affirming hormones had 60% lower odds of depression and 73% lower odds of self-harm or suicidal thoughts compared to those who didn't receive treatment. The Williams Institute found that transgender people who received needed gender-affirming medical care had lower rates of suicide attempts than those who needed it but couldn't access it. Research consistently shows that around 40% of transgender adults have attempted suicide at some point, but access to affirming care dramatically reduces these risks. I don’t know about you, but reducing risk of suicide is only the bare minimum of how I measure the quality of my life.
This case ultimately weighs documented medical benefits against speculative risks, while also raising fundamental constitutional questions about equal protection. From a medical standpoint, we have consistent evidence from doctors, patients, and families that gender-affirming care provides crucial mental health benefits, dramatically reducing suicide risk in a vulnerable population. The scientific evidence, while not perfect, consistently points toward these interventions being beneficial and relatively safe when properly administered.
From a legal standpoint, Tennessee's law allows these same medications for other conditions but specifically bans them for transgender youth. A child can receive hormone therapy to treat precocious puberty, but not to treat gender dysphoria. This selective application suggests the law isn't primarily about medical safety but about targeting a specific population, which raises serious equal protection concerns.
When Justice Kavanaugh framed this as "some people are going to be harmed either way," he created a problematic equivalence between documented, immediate suicide risk and potential future regret. This framing ignores that regret exists for virtually ALL medical decisions, yet we don't impose blanket government bans based on the possibility of regret. Medical decision-making properly weighs immediate, documented risks against potential future concerns, and in this case, the immediate mental health crisis facing transgender youth who can't access care represents a far more pressing and well-documented threat than speculative future regret. And why do people feel like the government has a role in helping people prevent regretting their own decisions? It's so absurd.
The question isn't whether any young person might ever regret treatment, but whether government officials should override medical professionals, parents, and patients in making these complex, individualized healthcare decisions.
Here is my take on this issue: we, as a society, have determined there are many decisions which are deemed not age appropriate for those under 18 or even 21 to make, ie., legally driving a motor vehicle alone, drinking alcoholic beverages, using tobacco products, voting, joining the military are just a few. Why shouldn’t the same perspective be applied to such life-altering decisions as gender surgeries or drugs? And, I do understand that in some cases the parents are on board with their child’s decision, however, it still THE CHILD that will ultimately be affected and therefore live with such. Admittedly, I am not a proponent of changing one’s gender at any age as I don’t believe gender can actually be changed. With that said, however, as adults we have the freedom to make our own choices. I believe it should, at least, be a decision left to adulthood when one’s brain has had time to more fully develop.
I appreciate your thoughtful perspective, and I think we actually share more common ground than it might initially appear. You're absolutely right that we protect minors from making certain decisions alone, and interestingly, your logic actually supports the use of puberty blockers rather than opposing them.
You mention waiting until adulthood when "one's brain has had time to more fully develop" to make major decisions. Puberty blockers do exactly this: they pause physical development, giving young people time to mature and make fully informed decisions at 18 or beyond. The medications are well-studied and reversible, so if someone stops taking them, puberty resumes normally. This allows for the careful, deliberate approach you're advocating for.
The key difference between your examples (driving, drinking, voting) and this medical situation is timing. If someone waits until 21 to drink alcohol, they haven't missed their chance - alcohol will still exist for the rest of their lives. But puberty is a one-time, irreversible biological process happening right now during adolescence. Without intervention, the body permanently develops in ways that may cause lifelong distress for transgender individuals. I just yesterday saw a news clip of a transgender senior citizen who runs a convenience store getting assaulted by random people for not appearing feminine enough for their tastes to pass as a woman, I guess. That's the kind of lifelong fate we are condemning Tennessee kids to right now. So waiting until 18 to address this isn't like waiting to drink, it's like waiting to treat any other time-sensitive medical condition.
Reasonable people can have concerns and suggestions for how the system should work. The current system requires extensive evaluation by medical professionals who specialize in this area, combined with parental consent and the young person's clear and persistent advocation for themselves. It's similar to how we handle other serious medical decisions for minors: we trust parents working with doctors to make the best choices for their children's health and wellbeing.
While I understand you have philosophical differences about gender identity, I think we can agree that government shouldn't override medical professionals and parents with blanket bans when they're trying to provide what they believe is life-saving care for their children. That feels like exactly the kind of government overreach that goes against American principles of individual liberty and medical freedom. If those principles don't exist, why shouldn't we expect the government to step in and impose the cultural values of any future president on our bodies?
Robn, how would you feel if the government forced you to take testosterone? If when you or your daughter or sister started puberty, they said you can’t go through female puberty - you MUST take testosterone. Every doctor and psychiatrist says you should NOT be forced to take testosterone, but the government doesn’t care.
I’m not trying to be a jerk - this is what the reality is for trans people. We are real people with lives and families.
No one wants to force anyone to be trans. We just want to be ourselves and live fulfilling lives.
You don’t have to accept us. You don’t have to get it. You can think we’re weird.
But if you place more value on the Cass Reports and the Bari Weisses of the world, on easily debunked and misrepresented data, on the cherry picked info and dehumanizing court cases that almost never allow actual trans people to speak on their experience… if you place more value on that than on the tens of thousands of stories that exist of trans people living joyous happy fulfilling lives post transition — I just want to respectfully ask that you reflect on why that is.
Respectfully, I don’t need to reflect on this topic. Since you have asked, as a believer in Jesus Christ, my faith abundantly clear on this. Also, I see everyone as a Child of God and as such, I try and treat all according to His word.
I also love Jesus and I know Jesus loves me just the way I am. Trans people are not broken or inhuman or confused. We’re just trying to make the best of the hand we were dealt. I know Jesus wants the other little kids like me to have a chance at a full life. It’s ok if you don’t feel the same.
Can you advise which words of Jesus indicate an opposition to gender transitioning? I’ve read the whole bible several times and don’t remember seeing it anywhere…
Sure! Here you are: The first two of many that come to mind are Genesis 1:27 “so God created man in His own image, in the image of God He created him; male and female He created them. 1 Cor 14:33 “For God is not a God of confusion but of peace “. And one more, this reiterates in the New Testament the same as in Genesis - Mark 10:6 “But from the beginning of creation, God made them male and female”. Please let me know if you have any questions. I am by no means a Biblical scholar but I will do my best to clarify.
I guess it begs the question - how can a God who is male create females in His image without there being some sort of… transition?
As for the confusion/peace scripture, I don’t get how this is an argument against transition. People who transition find peace through their transition - prior to their transition they are confused (not the term I’d typically use, but roughly meets this scriptural criteria). This scripture would seem to confirm that transitions which bring peace are godly.
I can provide answers to these questions if you genuinely want them from the Biblical perspective however, I am sensing you simply want to argue. Please advise if I am incorrect.
I suppose that depends on what you mean by “argue”. I’m not going to change my perspective - I’ve spent a lifetime constructing and then deconstructing my personal beliefs regarding biblical teachings. But I am interested in why you believe what you believe, and happy to read your insight if you’re open to me asking further probing questions.
The first question you asked regarding Him creating us in his image refers to our uniqueness among his creations. We are a reflection of God’s attributes and characteristics rather than actual physical resemblance. He created us with dominion over all the Earth. He equipped us with reasoning abilities, moral compasses and an intellect. These are direct reflections of Him. The verse was not to imply He is in human form and therefore we look like God. He created two distinct genders to fulfill his purpose of marriage (to become one flesh), to be able to procreate and populate the earth would be one example of his purpose for these two distinctions.
As for your second point, God is not about any confusion. To attempt to “change” one’s gender would mean God was confused when said person was created. His word is very clear on this. These are not my words…I am simply the messenger here.
Was God confused when He created intersex people or people with chromosomal abnormalities and thus have no single determinable gender?
And with that higher intellect that God gave us, were we not made to discover the incredible diversity that nature offers to us, including the diversity of chromosomal makeup which shows us that the two gender binary, while typical, is not the only possibility?
Re: Kavanaugh showing skepticism in the gerrymandering case for the need to decide things on racial lines based on AA decision- yeah, that shouldn't have been done away with, either. Super rich coming from a privileged white male (who has allegedly harmed someone at least once in the past)that we "don't need" to essentially worry about laws to ensure equality/equity. I'm sorry, I just cannot stomach this line of thought or many of the decisions this court/majority has made.
Perhaps this expert is not the best person to ask, but would love to find someone to opine about Mitch McConnell's ability to hold up a replacement for Ginsburg.
Thank you Sharon for the opportunity to look back at the conversation we had on the Skrmetti case. It was interesting to see conservative Supreme Court justices pointing to European countries as a model for how the United States should approach transgender medical care. These same justices rarely look to European models for other healthcare policy, gun safety measures, or social programs, but just because some European countries have grown more cautious about transgender youth care, suddenly international precedent becomes relevant. Very interesting.
However, the reality is more complex than a simple rejection of gender-affirming care. While some European countries have called for more individualized assessment protocols, most have not implemented blanket bans like Tennessee's law. There are ongoing methodological debates about evidence standards, as there should be, rather than a wholesale abandonment of care.
This is fundamentally a case where parents and doctors are better positioned than government officials to make individualized medical decisions, yet we see those who typically oppose government interference making exceptions when it comes to transgender youth. Why are “parents’ rights” crusaders so quick to abandon their principles here?
The main study that gets cited in these debates is the Cass Review. Critics of trans healthcare often claim it proves all gender-affirming care is dangerous, but this misrepresents its actual conclusions if you actually read it. The Review found no proof of danger, and only concluded that there’s insufficient evidence to make definitive conclusions about puberty blockers' impact on gender dysphoria and mental health, while acknowledging some concerns about bone health during treatment.
However, the Review's methodology has been extensively criticized by international experts. It applied randomized controlled trial standards so strict that it excluded 98% of existing studies as insufficient quality, despite puberty blockers being well-established as safe and reversible for other medical uses like precocious puberty. Why would it suddenly become dangerous for people who need it for a different reason? Multiple international medical organizations have pointed to the Review's selective and inconsistent use of evidence, noting that recommendations often do not follow from the data presented. The Review also notably failed to include transgender people in its planning and decision-making process, and several people involved had previously advocated for bans on gender-affirming care. It would be like only trusting science from the tobacco industry about the effects of smoking.
Meanwhile, we have growing scientific evidence that gender-affirming care provides significant mental health benefits for transgender youth. While individual studies have limitations (such as relatively small sample sizes and shorter follow-up periods) the evidence consistently points in the same direction across multiple research efforts. A 2022 study published in JAMA Network Open followed 104 transgender youth over 12 months and found that those who received puberty blockers or gender-affirming hormones had 60% lower odds of depression and 73% lower odds of self-harm or suicidal thoughts compared to those who didn't receive treatment. The Williams Institute found that transgender people who received needed gender-affirming medical care had lower rates of suicide attempts than those who needed it but couldn't access it. Research consistently shows that around 40% of transgender adults have attempted suicide at some point, but access to affirming care dramatically reduces these risks. I don’t know about you, but reducing risk of suicide is only the bare minimum of how I measure the quality of my life.
This case ultimately weighs documented medical benefits against speculative risks, while also raising fundamental constitutional questions about equal protection. From a medical standpoint, we have consistent evidence from doctors, patients, and families that gender-affirming care provides crucial mental health benefits, dramatically reducing suicide risk in a vulnerable population. The scientific evidence, while not perfect, consistently points toward these interventions being beneficial and relatively safe when properly administered.
From a legal standpoint, Tennessee's law allows these same medications for other conditions but specifically bans them for transgender youth. A child can receive hormone therapy to treat precocious puberty, but not to treat gender dysphoria. This selective application suggests the law isn't primarily about medical safety but about targeting a specific population, which raises serious equal protection concerns.
When Justice Kavanaugh framed this as "some people are going to be harmed either way," he created a problematic equivalence between documented, immediate suicide risk and potential future regret. This framing ignores that regret exists for virtually ALL medical decisions, yet we don't impose blanket government bans based on the possibility of regret. Medical decision-making properly weighs immediate, documented risks against potential future concerns, and in this case, the immediate mental health crisis facing transgender youth who can't access care represents a far more pressing and well-documented threat than speculative future regret. And why do people feel like the government has a role in helping people prevent regretting their own decisions? It's so absurd.
The question isn't whether any young person might ever regret treatment, but whether government officials should override medical professionals, parents, and patients in making these complex, individualized healthcare decisions.
Here is my take on this issue: we, as a society, have determined there are many decisions which are deemed not age appropriate for those under 18 or even 21 to make, ie., legally driving a motor vehicle alone, drinking alcoholic beverages, using tobacco products, voting, joining the military are just a few. Why shouldn’t the same perspective be applied to such life-altering decisions as gender surgeries or drugs? And, I do understand that in some cases the parents are on board with their child’s decision, however, it still THE CHILD that will ultimately be affected and therefore live with such. Admittedly, I am not a proponent of changing one’s gender at any age as I don’t believe gender can actually be changed. With that said, however, as adults we have the freedom to make our own choices. I believe it should, at least, be a decision left to adulthood when one’s brain has had time to more fully develop.
I appreciate your thoughtful perspective, and I think we actually share more common ground than it might initially appear. You're absolutely right that we protect minors from making certain decisions alone, and interestingly, your logic actually supports the use of puberty blockers rather than opposing them.
You mention waiting until adulthood when "one's brain has had time to more fully develop" to make major decisions. Puberty blockers do exactly this: they pause physical development, giving young people time to mature and make fully informed decisions at 18 or beyond. The medications are well-studied and reversible, so if someone stops taking them, puberty resumes normally. This allows for the careful, deliberate approach you're advocating for.
The key difference between your examples (driving, drinking, voting) and this medical situation is timing. If someone waits until 21 to drink alcohol, they haven't missed their chance - alcohol will still exist for the rest of their lives. But puberty is a one-time, irreversible biological process happening right now during adolescence. Without intervention, the body permanently develops in ways that may cause lifelong distress for transgender individuals. I just yesterday saw a news clip of a transgender senior citizen who runs a convenience store getting assaulted by random people for not appearing feminine enough for their tastes to pass as a woman, I guess. That's the kind of lifelong fate we are condemning Tennessee kids to right now. So waiting until 18 to address this isn't like waiting to drink, it's like waiting to treat any other time-sensitive medical condition.
Reasonable people can have concerns and suggestions for how the system should work. The current system requires extensive evaluation by medical professionals who specialize in this area, combined with parental consent and the young person's clear and persistent advocation for themselves. It's similar to how we handle other serious medical decisions for minors: we trust parents working with doctors to make the best choices for their children's health and wellbeing.
While I understand you have philosophical differences about gender identity, I think we can agree that government shouldn't override medical professionals and parents with blanket bans when they're trying to provide what they believe is life-saving care for their children. That feels like exactly the kind of government overreach that goes against American principles of individual liberty and medical freedom. If those principles don't exist, why shouldn't we expect the government to step in and impose the cultural values of any future president on our bodies?
Robn, how would you feel if the government forced you to take testosterone? If when you or your daughter or sister started puberty, they said you can’t go through female puberty - you MUST take testosterone. Every doctor and psychiatrist says you should NOT be forced to take testosterone, but the government doesn’t care.
I’m not trying to be a jerk - this is what the reality is for trans people. We are real people with lives and families.
No one wants to force anyone to be trans. We just want to be ourselves and live fulfilling lives.
You don’t have to accept us. You don’t have to get it. You can think we’re weird.
But if you place more value on the Cass Reports and the Bari Weisses of the world, on easily debunked and misrepresented data, on the cherry picked info and dehumanizing court cases that almost never allow actual trans people to speak on their experience… if you place more value on that than on the tens of thousands of stories that exist of trans people living joyous happy fulfilling lives post transition — I just want to respectfully ask that you reflect on why that is.
Respectfully, I don’t need to reflect on this topic. Since you have asked, as a believer in Jesus Christ, my faith abundantly clear on this. Also, I see everyone as a Child of God and as such, I try and treat all according to His word.
I also love Jesus and I know Jesus loves me just the way I am. Trans people are not broken or inhuman or confused. We’re just trying to make the best of the hand we were dealt. I know Jesus wants the other little kids like me to have a chance at a full life. It’s ok if you don’t feel the same.
Glad to hear you have a relationship with Him also. 😊
Can you advise which words of Jesus indicate an opposition to gender transitioning? I’ve read the whole bible several times and don’t remember seeing it anywhere…
Sure! Here you are: The first two of many that come to mind are Genesis 1:27 “so God created man in His own image, in the image of God He created him; male and female He created them. 1 Cor 14:33 “For God is not a God of confusion but of peace “. And one more, this reiterates in the New Testament the same as in Genesis - Mark 10:6 “But from the beginning of creation, God made them male and female”. Please let me know if you have any questions. I am by no means a Biblical scholar but I will do my best to clarify.
I guess it begs the question - how can a God who is male create females in His image without there being some sort of… transition?
As for the confusion/peace scripture, I don’t get how this is an argument against transition. People who transition find peace through their transition - prior to their transition they are confused (not the term I’d typically use, but roughly meets this scriptural criteria). This scripture would seem to confirm that transitions which bring peace are godly.
That’s fine
I can provide answers to these questions if you genuinely want them from the Biblical perspective however, I am sensing you simply want to argue. Please advise if I am incorrect.
I suppose that depends on what you mean by “argue”. I’m not going to change my perspective - I’ve spent a lifetime constructing and then deconstructing my personal beliefs regarding biblical teachings. But I am interested in why you believe what you believe, and happy to read your insight if you’re open to me asking further probing questions.
The first question you asked regarding Him creating us in his image refers to our uniqueness among his creations. We are a reflection of God’s attributes and characteristics rather than actual physical resemblance. He created us with dominion over all the Earth. He equipped us with reasoning abilities, moral compasses and an intellect. These are direct reflections of Him. The verse was not to imply He is in human form and therefore we look like God. He created two distinct genders to fulfill his purpose of marriage (to become one flesh), to be able to procreate and populate the earth would be one example of his purpose for these two distinctions.
As for your second point, God is not about any confusion. To attempt to “change” one’s gender would mean God was confused when said person was created. His word is very clear on this. These are not my words…I am simply the messenger here.
Was God confused when He created intersex people or people with chromosomal abnormalities and thus have no single determinable gender?
And with that higher intellect that God gave us, were we not made to discover the incredible diversity that nature offers to us, including the diversity of chromosomal makeup which shows us that the two gender binary, while typical, is not the only possibility?
Re: Kavanaugh showing skepticism in the gerrymandering case for the need to decide things on racial lines based on AA decision- yeah, that shouldn't have been done away with, either. Super rich coming from a privileged white male (who has allegedly harmed someone at least once in the past)that we "don't need" to essentially worry about laws to ensure equality/equity. I'm sorry, I just cannot stomach this line of thought or many of the decisions this court/majority has made.
Perhaps this expert is not the best person to ask, but would love to find someone to opine about Mitch McConnell's ability to hold up a replacement for Ginsburg.