What Pediatric Gender Clinics Have In Common With Opioid ‘Pill Mills’

Hundreds of pediatric gender clinics have proliferated across the country in recent years to meet growing patient demand – not medical necessity – of trans-identified youth.

It is an unfortunate reality that market demands, rather than sensible science, can be powerful drivers of the medical industry, often to the detriment of the patient. Sometimes the result is benign, and patients may simply end up with ineffectual treatment.

But sometimes consumer demand results in the creation of a new infrastructure to support the proliferation of drugs that are anything but benign, like the expansion of pain clinics to meet the demand of opioid users — an epidemic that claimed nearly 1 million lives.

It’s happened throughout history — a novel diagnosis emerges in the public periphery, followed by a surge of self-reported cases, and then clinics begin to propagate to meet the new patient demand.

Is “gender dysphoria” following a similar pattern? A decade ago, gender clinics were few and far between. But in recent years, as gender dysphoria diagnoses have become de rigueur for mentally distressed children and adolescents, over 400 gender clinics have sprung up in North America. The “gender-affirmation” model is the current standard of care deployed by pediatric gender clinics across the country. It effectively puts children in the driver’s seat to dictate the terms of their own sex change, and has allowed clinics to distribute puberty blockers, cross-sex hormones and gender-related surgeries without rigorous mental health assessments.

Medical professionals are encouraged to “affirm” a child’s chosen sex identity, despite current evidence indicating that roughly 60–90% of children who identify as transgender, but do not socially or medically transition, will no longer identify as transgender in adulthood.

Pain clinics dispensing opioids were once thought to be legitimate and necessary while operating under the medically-accepted guise of “pain management.” After people caught on to their illegal conduct, approximately 600 pain clinics were shut down, and given the stigmatized nickname “pill mills” to denote the cavalier way they dispensed dangerous narcotics to addicted patients.

What opioid prescriptions for moderate pain and pediatric medical transition have in common is that they both lack legitimate medical necessity, yet have been permitted to function without proper patient assessments or safeguarding.

Explosive increases in patient numbers were largely ignored, negative outcomes and critics were initially dismissed, and protocols were uncritically adopted and given the stamp of approval by the medical establishment, despite the ethical concerns and the fact there were no long-term studies to support their use.

Prescribing more opioids became equated with being compassionate. Opioids were marketed by pharmaceutical companies as safe and nonaddictive. In the same vein, medical transition is often seen as the compassionate response to children with gender dysphoria, and portrayed as safe and consequence-free.

The director of the pediatric gender clinic at Boston Children’s Hospital made the startling admission that puberty blockers are handed out to children “like candy” to a “skyrocketing” number of new patients, despite the fact that they are known to cause infertility and are not approved for their off-label use by the FDA. A new study of nationwide hospital databases found that at least 1,130 adolescents between 2016 and 2019 received “gender-affirming” chest surgeries in the U.S.

In the beginning of the opioid epidemic, those first suffering and showing signs of addiction were dismissed, and the ever-increasing danger was ignored. Similarly, detransitioners and medical professionals who have begun to sound the alarm on fast-tracking children into medical transition are shouted down and verbally abused.

Purdue Pharma, the manufacturer of OxyContin, used a statistic in their marketing that was successful at getting doctors to ignore addiction concerns and prescribe the deadly narcotic. “The rate of addiction is less than 1%,” was plastered all over their advertisements and in their sales pitches, despite the fact that this number was not derived from any study, but a four sentence letter in a medical journal.

Trans rights activists also rely on a 1% statistic to dismiss the negative experiences of “outliers” and any criticisms of pediatric “gender-affirming” care. They often claim that “the rate of transition regret is 1%,” despite the fact that this number is pulled from a study of transition regret in adults, rather than the new cohort that people are most concerned about: adolescents with rapid-onset gender dysphoria (ROGD).

Proponents of “gender-affirming” care have worked hard to portray it as “lifesaving medical treatment” and “suicide prevention” on the basis of the “affirm-or-suicide” myth, a debunked narrative that claims trans-identified minors are more likely to commit suicide if they are denied “gender affirming” medical treatments.

According to the affirmation model, “gender identity” is subjective and determined by the individual – it is to be believed, not questioned, and treated with prescription medicine. Jacqueline Cleggett, an infamous pill mill clinician who pleaded guilty to conspiracy to dispense and distribute controlled substances, said the same of her pain patients when interviewed in the Netflix

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