The most noteworthy aspect of Tandy Aye’s discussion is her concession that the doctors who administer 'gender affirming therapy' are sterilizing these children.

In the competition for the most hard-left doctor treating children who are confused about their sex (“transgender” kids), Dr. Johanna Olson-Kennedy of Children’s Hospital Los Angeles has maintained a strong lead. Olson-Kennedy promotes medicalizing sex-confused children with puberty blockers, cross-sex hormones, and surgery.

How radical is she? Radical enough to airily reject the idea that all such children should at least receive psychological counseling (“I don’t send someone to a therapist when I’m going to start them on insulin”) and to minimize the seriousness of removing healthy but currently unwanted organs (“if you want breasts at a later point in life, you can go and get them”). Olson-Kennedy is now using federal research dollars to administer sterility-inducing cross-sex hormones to children as young as eight years old to see what happens.

It doesn’t get more politicized at kids’ expense than that. Or does it?

Stanford pediatric endocrinologist Tandy Aye is determined to try. While Olson-Kennedy is injecting powerful hormones into physically healthy children, Aye isn’t satisfied with merely medical interventions. She wants to allow (and encourage) surgeons to perform mutilating surgery on children (“older adolescents,” she says) who are under 18 and therefore currently unable to agree to such permanent and life-altering procedures.

Aye’s recent TED talk on this issue is illuminating in several ways. One is her slavish adherence to the new grammatical mandates of the transgender orthodoxy. She consistently refers with female pronouns to a boy who identifies as a girl.

His parents realize they have “a daughter with a penis” (1:10). He was “assigned” a sex at birth (3:30). His treatment isn’t gender “reassignment” therapy but gender “affirmation” therapy (1:40). Similarly, surgery to remove healthy organs is gender-affirming surgery, or GAS. She smoothly strings together these misleading terms as though they are inarguably correct, thus suggesting that people should ignore the jarring dissonance between what they’re hearing and what they know to be true.

Aye also acknowledges but dismisses the obvious reason that states have set 18 as the age of consent: that minors are too immature to make life-altering medical decisions. Not to worry, Aye says, because all transgender minors know exactly what they’re doing: “The transgender patient may be one of the most well-informed patients. Who else has had years of psychological evaluation, months of medical therapy, and has thought of this one procedure for so long?” (7:00).

Perhaps Aye should have a chat with Olson-Kennedy, whose patients may very well have avoided “years of”—or any—psychological evaluation. Perhaps she should read the stories of frantic parents who helplessly watched their children get herded into medical treatment with little or no exploration of what might underlie that fixation on “this one procedure.”

The most noteworthy aspect of Aye’s discussion is her concession that the doctors who administer Gender Affirming Therapy (GAT) are sterilizing these children. The GAT crowd tends to shy away from this admission, preferring not to dwell on the fact they may be ruining lives.

Minor children clearly cannot grasp the full extent of problems caused by infertility. Adults who struggle with this condition suffer significant psychological distress, with affected women experiencing distress “comparable to the experience of a life threatening illness.” Rather than acknowledge this bleak future for their patients, GAT doctors typically downplay or ignore the physical and emotional ramifications of what they’re doing.

Aye is more forthcoming. Her argument in favor of GAS for minors is that puberty blockers and cross-sex hormones have destroyed the child’s future reproductive capacity anyway, so why not remove the now useless organs? She explains (beginning at 6:10): “[A]s soon as puberty blockers were added and then estrogen was added to [the boy’s] therapy, [his] testes never developed. In fact, she [sic] does not make any sperm. And her [sic] reproductive capability to be a biological parent has been eliminated.”(Emphasis mine.)

Having blithely announced that she and her fellow practitioners have robbed this child of one of the most profound and meaningful experiences of human life, Aye concludes: “And in medicine, don’t we often recommend the removal of non-functional organs, like an appendix? So does it make sense for [the minor patient] to wait until she’s [sic] 18, or should older adolescents be allowed to have surgery before the age of 18?”

We’ve already destroyed the organ, Aye is saying, so we might as well lop it off. This is medical practice in the 21st century. Hippocrates indeed.

Following this perverse reasoning, Aye proposes that age of consent be replaced with the number of years the patient has lived in imitation of the opposite sex (although she doesn’t phrase it quite that honestly). If a young boy begins wearing dresses and is “affirmed” in this behavior by his family, his teachers, and his therapists, and so is not surprisingly still confused in adolescence, he should be allowed to undergo surgical sterilization and painful reconstructive procedures while still a minor.

Aye doesn’t specify how many years of charade would be required. We can only assume that whatever number is chosen will steadily fall as the GAS surgeons tap greater patient pools for greater insurance payments. She is seemingly insouciant about this outcome. Preparation for and recovery from this surgery is difficult, she concedes, so doesn’t it make sense to have the child undergo it while he or she is still at home under parental care? Win-win.

But what about the irreversibility of these procedures? Aye doesn’t mention that. What about the fact that thousands of patients who have endured surgical alteration, even as adults, have come to regret it? No mention of that either. What about the stubborn persistence of high suicide rates among people who have undergone the surgery? From Aye, crickets. What of the disturbing statistics showing the sudden and enormous increase in the number of children and adolescents claiming to be the opposite sex lately? Shouldn’t we at least investigate this phenomenon before putting children under the knife? Aye is apparently unconcerned.

That such reckless recommendations are coming from an apparently licensed physician at a formerly respected medical institution shows the depth of the rot that has infected the medical profession. Lives of children and their families are being destroyed, day by day, while the people and organizations who should be policing this are either asleep at the switch or simply craven cowards. But Aye and her fellow practitioners will make lots of money and get invited to present TED talks to the enlightened. That should go a long way toward easing the conscience.