I wish my paediatrician understood me

I have been thinking about a post I came across recently, written publicly by a paediatrician. I am not going to name them, because this is not about one person. It is about a position I see held in consulting rooms around the world, presented in the language of caution and evidence, and I want to talk about what that position costs the children it claims to protect.

The paediatrician wrote that most children with gender dysphoria desist if you do not rush them into affirmation. That puberty blockers are not a harmless pause. That the Cass Review and several European health authorities found the evidence for benefit to be weak and the risks real. That medicalising gender-distressed children is not care. It is, they wrote, experimental.

I want you to imagine being twelve years old, sitting in that doctor's office.

You have rehearsed what you are going to say. You have found the words for something that has been true about you for as long as you can remember. You have maybe even written notes on your phone, because you know how quickly the words can disappear when someone is looking at you waiting for you to explain yourself. Your parent is beside you. You trust this person. They are a doctor, and doctors help.

And then the doctor looks at you and says, in effect: most children like you change their minds. Let's wait and see.

What happens next is not a neutral pause. It is not a careful clinical decision that keeps all options open. What happens next is puberty, and puberty does not wait for anyone to feel ready.

I know a family whose child, I will call him a boy because that is what he is, went through exactly this. He was eleven when they first sought help. His mother had known something was wrong, in the way that mothers do, not wrong with him, wrong with the situation, wrong with the gap between who he was and how the world kept insisting on seeing him.

The paediatrician was kind. That is the detail I keep returning to, because it matters. This was not a cruel person. They listened carefully, they asked thoughtful questions, and then they gently explained that children often go through phases, that adolescence was confusing, that the most loving thing was not to intervene.

His mother told me about the drive home. He did not cry. He sat in the back seat and looked out of the window and did not say anything for a long time. When she asked how he was feeling, he said, "I thought he was going to help us."

She told me that sentence has never left her.

They did not go back. They found their way, eventually, to a doctor who understood, and he got the support he needed. But by then, two years had passed. Two years of the wrong puberty arriving in his body, doing things he had not wanted and could not undo. He is doing well now. He is a teenager who laughs at his own jokes and has strong opinions about music and loves his dog with a fierce, uncomplicated devotion. But those two years belong to him, and he will never get them back, and the changes that happened in them are real.

That is what "wait and see" actually means, when the thing you are waiting to see is whether puberty resolves the question.

Now let me talk about the evidence, because the paediatrician's post leaned hard on evidence, and I think it deserves a direct answer.

The claim that most gender-dysphoric children desist is one of the most persistently misused statistics in this whole debate. It comes from older studies using diagnostic criteria that would catch a much broader group than we are talking about today: children who played with toys or wore clothes associated with the other gender, children who might today not be considered gender dysphoric at all. When you narrow the group to children who consistently, persistently, and insistently identify as a different gender, the picture looks very different. The World Health Organisation, the American Academy of Pediatrics, the Endocrine Society, WPATH, the American Academy of Child and Adolescent Psychiatry, and the American Medical Association all endorse gender-affirming care. These are not fringe voices. They are the bodies that set the standard of care for children around the world.

The American Academy of Child and Adolescent Psychiatry reaffirmed that position in 2025, under significant political pressure to do otherwise. They looked at the same evidence being waved around in that paediatrician's post and they did not change their guidance. That matters.

The Cass Review, which the post cited as a cornerstone of its argument, has been widely criticised internationally. Many gender medicine specialists and researchers have published detailed rebuttals of its methodology and conclusions. It is not the neutral, authoritative scientific verdict it is sometimes presented as. Citing it as though it closes the argument is a choice, and it is worth knowing what kind of choice that is.

Puberty blockers are not experimental. They have been used for decades, including in children with precocious puberty, meaning puberty arriving far too early. They pause puberty. They give a child time. The risks associated with them are real, as the risks associated with every medicine are real, and they are managed through monitoring, which is what good medical care does. The risk of withholding them, the bone density that grows in the wrong shape, the voice that drops, the breasts that develop, the body that becomes a source of daily anguish: those risks are just as real, and a paediatrician who names one set without naming the other is not being balanced. They are making a choice about whose suffering counts.

I think about why a kind, thoughtful, intelligent doctor ends up in that position. I do not think it is usually malice. I think it is, genuinely, an attempt at caution. The problem is that caution is not neutral. Inaction is a decision. Waiting is a treatment, with its own effects and its own risks, and those effects fall entirely on the child.

There is a version of the argument that frames itself as putting the child's long-term health first. I understand the instinct. Paediatricians care about long-term health. But if we apply that standard fairly, we should be equally scrutinising the long-term health consequences of leaving a child to go through the wrong puberty: the documented mental health impacts, the rates of depression and anxiety, the self-harm, the surgical interventions later in life that might have been avoided or reduced with earlier support. A framework that calls one set of risks caution and dismisses the other as ideology is not evidence-based thinking. It is a framework that has already decided who deserves the benefit of the doubt.

The children sitting in those offices deserve the benefit of the doubt.

The family I mentioned found their way through. Not every family does. I know children who did not get there in time. I know young people who are now adults carrying in their bodies the evidence of a puberty they never wanted, who are managing well, who have built beautiful lives, but who would have chosen differently if the choice had been offered to them earlier. I know families who fought for years against doctors who told them they were doing harm by listening to their child, when the harm was coming from somewhere else entirely.

And I know paediatricians who get it right. Doctors who ask a child: who are you? What do you need? How can I help? Doctors who understand that their job is not to decide whether a child's identity is real, but to support the child in front of them. There are more of them than the current noise might suggest, and they are doing extraordinary work under conditions that are getting harder, not easier.

To any child who has left a medical appointment feeling dismissed, disbelieved, or pathologised: that appointment was not the last word on who you are. The doctor's doubt is not evidence of anything except the limits of their understanding. You are not a phase, or a statistic, or a question that needs to be settled by waiting. You are a person, and you deserve a doctor who knows that.

To any paediatrician reading this who has held or still holds the position in that post: I am not asking you to abandon evidence. I am asking you to look at all of it, including the evidence of what happens to children who are not helped. Look at the guidelines. Look at which organisations have examined this carefully and where they have landed. And then look at the child in front of you and ask what they are telling you, and whether the most important thing you can do today is believe them.

If there is a story that you would like to share or hear about, just let Sammy know.

Dr Helen Webberley is a Gender Expert, Medical Educator, and advocate, and the founder of GenderGP. She writes about gender diversity, trans healthcare, and the lives at the centre of both.