Should a person under the age of 16 be able to decide to have their penis or breasts surgically removed? Should they be free to forfeit their sexual function and fertility? What about halting their sexual development with a view to embarking on “sex reassignment” later?

The New York Times seems to think so in its report entitled, “Doctors Could Face Criminal Charges for Treating Transgender Teens,” a critique of South Dakota’s proposal to ban medical experimentation on gender-confused children. During its report, the Times does not refer to the name of the South Dakota bill, the Vulnerable Child Protection Act, but instead focuses on the various conservative groups who support the bill. However, while researching a lengthy cover story for National Review, I discovered the following:

A study published in 2017 in the Journal of Sexual Medicine entitled “Age Is Just a Number” endeavored to investigate “WPATH-affiliated surgeons’ views, experiences, and attitudes toward performing vaginoplasty,” i.e., castration, inversion of the penis, and dilation of a cavity to form a pseudo-vaginal canal, “on transgender minors in the United States.” (WPATH is the World Professional Association for Transgender Health.) Of 20 surgeons who were interviewed, eleven reported having done the procedure “1 to 20” times on children under age 18. The youngest patient was 15. One surgeon gave an indication as to why this might be a bad idea. He or she described the new clinical landscape as a “new Wild West” where “a bunch of solo practitioners, basically cowboys or cowgirls who kind of build their little house, advertise and suck people in.” In the U.K., the Times of London has covered a whistleblower scandal at Britain’s main clinic for gender-confused youth, from which multiple clinicians have resigned, citing dangerous, experimental, and inadequate care. The authors of the Journal of Sexual Medicine study also remarked on “the legal impossibility to obtain informed consent from the underage patient.” But that isn’t the only problem with relying on the feelings of minors. Many of these underage patients are already damaged and vulnerable. At the Gender Infinity Conference (an “Affirming Space to Empower Gender Diverse Individuals”) in 2015 in Texas, Olson-Kennedy told an audience that “a not-insignificant” number of young people at her clinic “have actually done sex economy, sex work, for a place to live or something to eat,” and that “a lot experience homelessness, precarious housing, and have been in foster care.” This is consistent with her published research. A study from 2015 included transgender youths who had prostituted themselves, been homeless, and abused drugs; a follow-up study in 2018 failed to account for 41 percent of the participants, meaning that no one knows what has happened to them.