In American debates on transgender issues, the question of the consequences of “gender-affirming therapy” is being raised with increasing frequency. Critics argue that such practices cause harm and exert pressure on individuals—particularly the young—who may later struggle when trying to reverse earlier choices.
The tragedy at a Catholic school in Minneapolis, where the shooter identified as transgender, has reignited the controversy. Since 2018, according to conservative commentators, there have been at least seven armed attacks carried out by individuals who identified as transgender, though such details rarely receive broad coverage in the media.
Attention has also turned to the investigation into the murder of right-wing activist Charlie Kirk. The suspect, Tyler Robinson, was reportedly in a relationship with a transgender man and influenced by ideas of gender self-affirmation.
Another source of contention is the growing number of cases of detransition, when individuals abandon their previous identity and report severe psychological and physical consequences. Critics say many feel pressured by the very community that once supported their decision but later condemns them for reversing it. In the manifesto published by the Minneapolis shooter, he mentioned wanting to return to his previous gender identity but considered it impossible.
In today’s medical field, the prevailing view is that when a teenager struggles with gender identity, their new choice should be affirmed. Parents are often told that failing to support their child’s decision could lead to tragic consequences, including the risk of suicide. In practice, this frequently means prescribing puberty blockers and hormone therapy. Yet studies show these drugs do not simply “pause” development but are linked to serious risks—from infertility to osteoporosis. The next step is often surgery, which irreversibly alters the body and creates lifelong dependence on pharmaceutical treatments.
Critics of this approach argue that it is not care but a distortion of terms. In their view, “empathy” in this context means reinforcing an illusion rather than helping a teenager work through an identity crisis. Such a path, they stress, may only deepen inner pain and insecurity.
Supporters of religious tradition put forward a different concept of compassion. They argue that the human body is created as it is meant to be, and that the role of loved ones is to support a teenager through psychological struggles without resorting to radical medical interventions. In this view, genuine compassion lies not in agreeing with what is seen as a misconception, but in the willingness to accompany and sustain someone on the path to recovery.
Four women—Chloe Cole, Prisha Mosley, Luka Hein, and Soren Aldaco—have filed lawsuits against medical institutions, claiming that as teenagers they were rushed into gender-affirming therapy without adequate and prolonged psychiatric support. To date, 28 malpractice and misconduct lawsuits connected to such practices have been registered.
Critics point out that a significant number of children and adolescents have been subjected to pressure from the medical community and the pharmaceutical industry. According to their data, the cross-hormone market is valued at $1.73 billion, while clinics and hospitals build business models around surgical procedures that irreversibly alter the body—often before patients reach adulthood.
The American Medical Association (AMA), the largest professional organization of physicians, opposes legislative restrictions on gender-affirming care. Jesse Ehrenfeld, the association’s president and its first openly gay leader, stated: “We must expand, not restrict, access to care for transgender youth.” Critics suggest the AMA’s stance aligns closely with the interests of the pharmaceutical industry.
Donald Trump’s administration has taken the opposite course. The president signed an order banning puberty blockers, cross-sex hormones, and surgical procedures for individuals under the age of 19. A US Department of Health report released in May 2025 stated that such therapy causes irreversible harm and may lead to severe psychological and physical disorders. The Department of Justice is reportedly also considering restrictions on gun ownership for people identifying as transgender, citing statistics on mass shootings.
At the same time, legislative initiatives are advancing at the state level: 27 states have already passed laws restricting gender-affirming care for minors. According to the organization Concerned Women for America, at least 26 hospitals and clinics in the United States have stopped providing such services or shut down the relevant departments altogether.
Another contentious issue is the ban on so-called “conversion therapy.” It is fully prohibited in 24 states and the District of Columbia, while five states enforce partial bans. Opponents of these restrictions argue that eliminating such methods deprives teenagers of alternative forms of psychotherapy.
Thus, a contradictory picture is emerging around gender medicine in the United States: part of the medical community advocates expanding access, while federal authorities and a significant number of states are moving toward restrictions. The debate over which approaches can be considered genuinely protective and therapeutic for young people remains sharp and politically charged.