The ongoing annual meeting of the Endocrine Society in Boston presents a crucial moment for one of North America’s most influential medical organizations. This society has long been a steadfast proponent of aggressive and irreversible gender-affirming treatments for children, a stance that demands a serious re-evaluation. Both legal and medical communities look to this society for guidance, and it has indeed played a powerful role in shaping policy and treatment guidelines. Yet, recent developments offer compelling reasons for the Endocrine Society to revisit and revise its position for the well-being of children.
As a practicing endocrinologist who attended last year’s meeting in Chicago, I am acutely aware of the weak foundation on which the support for gender-affirming treatments for minors stands. Since 2017, the Endocrine Society has backed these treatments based on what it admitted to be “low” and “very low” quality evidence. The organization’s guidelines prioritize a child’s physical appearance over the potential medical and psychological harms these vulnerable young individuals face. This endorsement has led to a broad application of puberty blockers and cross-sex hormones in children across the United States and Canada, setting the stage for eventual sex-change surgeries.
However, resistance to these controversial practices has been mounting. The United Kingdom’s Cass Report, authored by pediatrician Dr. Hilary Cass, critically examined and rejected the developmental rigor of the Endocrine Society’s guidelines, highlighting the lack of credible evidence concerning the long-term outcomes of these invasive treatments. The Cass Report suggests that a medical pathway is seldom the optimal approach to managing children’s gender-related distress—a sentiment backed by data showing that upwards of 80% of children who question their gender eventually desist, with some studies suggesting this number could be as high as 94%.
Instead of needless and potentially harmful medical interventions, these children would benefit far more from counseling, caution, and time to understand their identities. This approach contrasts starkly with the Endocrine Society’s current guidelines. The question now is whether the society will pivot to put children’s health and evidence-based medicine first. Unfortunately, early indications are far from encouraging. The Endocrine Society’s response to the Cass Report relied on emotional arguments, claiming gender-affirming care is “needed and often lifesaving,” a stance disconnected from rigorous medical science and ethics.
Moreover, the society has embarked on its own review of the evidence, though this effort appears compromised from the outset. The panel overseeing the review includes several physicians with conflicts of interest and ties to the World Professional Association for Transgender Health (WPATH), a group known for its advocacy rather than its impartiality. WPATH has previously used the Endocrine Society to lend ungrounded demands an air of medical credibility and has a track record of burying inconvenient evidence.
Hope, however, may still linger in the form of the Endocrine Society’s newly appointed president, Dr. John Newell-Price, who hails from the UK—a country now steering towards a more evidence-based and cautious approach regarding children with gender distress. If Dr. Newell-Price is truly dedicated to upholding medical science and ethics, he could leverage this week’s meeting to initiate a transformative shift in how the society addresses these critical issues.
If the Endocrine Society fails to make this crucial course correction, it will leave Americans with no choice but to disregard this once-venerated institution. Judges should dismiss its legal support for aggressive and experimental interventions, legislators should reject its testimonies against protective laws, and both physicians and patients should seek guidance elsewhere. The time for the Endocrine Society to turn back is dwindling. The question is whether it will seize this chance or continue down a path fraught with peril for our nation’s children.
