Gender-Affirming Treatment and The Placebo Effect

“Clayton argues that the findings of modest ‘benefits’ of hormonal and surgical ‘affirming’ interventions are compromised by the placebo effect—the expectation of benefits heavily promoted by enthusiastic providers, and indeed the entire cultural narrative.  Clayton poses the next logical question: If the placebo effect is not only in play but is also likely responsible for the reported short-term benefits, is that a problem—as long as the patient gets better? Clayton’s overview of the significant health risks of euphemistically-termed ‘gender-affirming’ interventions is a powerful reminder of why, while the ‘placebo effect’ is a welcome addition to the plethora of ways in which medical treatment may help patients, it should only be called upon when the treatment itself has proven net-beneficial in a controlled trial—something that has never occurred in pediatric gender medicine.

Short-term benefits from placebo effects are common and may even endure, depending on the condition (e.g., they may aid in treatment of heart disease and depression, but do not shrink tumors). However, the price that young gender dysphoric patients will pay for the benefits of the “placebo” effects is unacceptably high, as it involves infertility, sexual side effects, and a growing list of medical health risks—along with the certainty of lifelong medical patienthood and the risk of regret over irreversible interventions. Currently, as many as 30% of individuals (19% of natal males and 36% of natal females) who initiate “gender-affirming” interventions, stop them 4 years later; however the harmful effects of these interventions are often life-long.”