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When a sex change seemed the only realistic option, we referred them to an endocrinologist for assessment regarding puberty blockers; if prescribed, we continued monitoring their progress to ensure their ongoing safety. (Even so, we had qualms, given a lack of evidence of long-term impact.)

However, we also felt strongly that irreversible medical intervention such as hormones and surgery should be postponed until we could be certain that the individuals were fully able to understand that there would be no going back. We were quite willing to accept that individuals might change their mind or wish to slow the process down. In short, we did what is considered best practice in the field of ASD and gender discomfort.

Activists would have the public believe that anyone who expresses a wish to be the other gender should be allowed and encouraged to do so. Credulous politicians have translated their demands into law. To date, however, there is no evidence that there is such a thing as a “true” trans, just as there is no marker that would identify a “false” trans. To accept the thinking and wishes of those with ASD at face value, without understanding why they feel the way they do, is not a kindness, and may in fact be extremely damaging.

Susan Bradley is a consultant child psychiatrist, formerly chief of psychiatry at Hospital for Sick Children and head of child and adolescent psychiatry at the University of Toronto. She is an emeritus professor at U of T.