There’s a very important article by Jennifer Block out today in the New Atlantis. She’s an investigative journalist who has been on this beat for the British Medical Journal for some time. She finds that many European health agencies have revised the standard of care for minors with gender dysphoria, concluding that the harms of medical transition outweigh the potential benefits. But U.S. agencies have not done so. They still promote “gender affirmation” for young people as the standard of care. These agencies and the standards they set determine the outcomes of lawsuits and court cases, and they have a major effect on public opinion over time. Block speaks with some doctors in America who have been trained in “gender affirmation” and have come to question it, and she outlines the pressure they face to conform or be silent.

England’s National Health Service is in the process of re-training therapists to meet this moment. But in the United States, every professional organization in the mental health field — the American Psychiatric Association, the American Psychological Association, the corresponding groups for psychoanalysts, therapists, counselors, and social workers — all continue to stand behind the affirmative model: accept a patient’s gender identity as innate and off-limits for exploratory discussion, regardless of the patient’s age or general mental health.

This, says Paul Garcia-Ryan, executive director of a small but growing organization for mental health professionals called Therapy First, has put his colleagues in an unprecedented — and unfortunate — position, asking them to treat trans patients in an exceptional way that precludes the precepts of therapy itself: asking questions and exploring emotions so that their clients may better know themselves. In the context of young people, he says, the model disregards the fluid nature of adolescent identity formation.

This is the heart of the battle. Read the whole thing.