Protests and reactions to the draft S2k guideline
In March 2024, the draft of the S2k guideline “Gender Incongruence and Gender Dysphoria in Childhood and Adolescence: Diagnosis and Treatment” was presented to the press. It has provoked a large number of protests and reactions, and there are some parallel publications on the same topic. To keep track of it all, TTSB has created a timeline of events (in reverse chronological order – it's best to read from ►bottom to the top):
Swiss child psychiatrists divided over S2k-LL
On 14 November, the Society for Child and Adolescent Psychiatry and
Experts disagree on the best way to treat transgender young people, tagesanzeiger.ch, 10.11.2024
What helps? What harms?
Internationally, there is disagreement among experts on the best approach to helping young people who find themselves in a gender emergency. A new article by Kasia Kozlowska et al. provides an overview of the state of so-called gender medicine for young people in 13 Western countries. Germany is not represented.
Behind the Rainbow
Publication of Dr Alexander Korte's book with the subtitle "An evidence-based look at the gender debate and gender dysphoria in minors".
Presentation instead of panel discussion
Instead of an announced panel discussion at the Congress of the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) Professor Romer and Ms Maur spoke about the S2k draft guideline - No reasons for the
Rostock Rumble, A. Korte, T. Banaschewski, YT
No discussion, FAZ, 10.10.2024 - FAZ, 10.10.2024 - Report on the Rostock Rumble by Annegret Böhme Twitter
Meeting of the German Medical Association / DGKJP
At the end of August 2024, the Executive Board of the German Society for Child and Adolescent Psychiatry and Psychotherapy (DGKJP) met with the President of the German Medical Association (BÄK). The reason for this was a resolution critical of the guidelines entitled
Treatment of gender dysphoria in minors which the German Medical Association had passed in May with a 2/3 majority. The DGKJP demanded that the supreme body of the German medical profession withdraw this resolution.
The position of the Medical Association was represented by the professors of child psychiatry Banaschewski (Mannheim), Roessner (Dresden) and Zepf (Jena) as well as Dr A. Korte (Munich), who provided expert testimony. The result was as follows:
"The decision of the Medical Assembly was not revoked."(Source)
The outcome of the final consensus process on the guideline by the participating specialist societies will still be announced for autumn 2024.
Criticism unwanted
A group of gender-affirmative activist practitioners/providers try to silence journalists critical of the gender-affirmative approach and the S2k draft guideline for the treatment of gender dysphoric minors.
TTSB appeals to the Federal Ministry of Health
Parents from the initiatives Transteens Sorge berechtigt and parentsofROGDKids write to Health Minister Lauterbach (BMG) expressing their concerns about routine gender-affirmative interventions with gender dysphoric minors, in particular the related S2k draft guideline:
- The S2k draft guideline is based on scientific findings from the last decade.
- It does not meet the standard for a credible evidence-based guideline.
- While more and more countries are turning away from the WPATH recommendations, Germany insists on the affirmation-only trend.
- The consensus-based S2k level is inadequate. Our teenagers need evidence-based treatment recommendations (S3).
Announcement of the guideline publication
In an Article by Thomas Thiel (FAZ, 25.06.24) Ms Maur (member of the LL Guideline Commission) says that the guideline "will be adopted by September if possible".
At the DGKJP congress in September, however, it was suggested that the guideline would only be published at the end of the year.
Several professional associations call for guideline to be revised
The professional associations GDPPN and SGKJPP (Switzerland) distance themselves from the S2k draft guideline and call for a revision. The DGSMSP does not endorse the draft guideline either.
- • Hormonal and surgical interventions should be reserved for a small number of cases after mandatory "multi-professional child and adolescent psychiatric and somatic diagnosis"
- • Treatment should be subject to a positive vote in the Ethics Committee
- Treatment should only be given as part of clinical studies.
- • A call is also made for a systematic review of the specialist literature since 2020 angemahnt.
Data on the frequency of F64.x diagnosis
Data becomes available for the first time on the frequency of the F64.x diagnosis (= gender identity disorder), psychiatric comorbidities and desistance in minors and young adults in Germany (Ulm Study)
SEGM analysis
The Society of Gender Based Medicine (SEGM) publishes its analysis of the S2k draft guideline. It criticises many methodological and content-related aspects and demonstrates that the draft does not meet the basic requirement of credible, trustworthy, evidence-based guidelines.
German Medical conference urges caution
The 128th German Medical Assembly passes a resolution Treatment of gender dysphoria in minors on 10 May 2024 which cautions against youth transitions in medical practice.
TTSB writes to the German Medical Association
Parents sound the alarm: The safety of our teenagers as patients is at risk! In an open letter, Transteens-Sorge-berechtigt (TTSB) calls on the German Medical Association to stop the guideline. TTSB does not believe that early and systematic gender-affirming treatment through PB, CSH and OP is safe, appropriate or ethically acceptable as it turns our physically healthy young people into lifelong patients and disproportionately restricts their future without any reasonable prospect of 'curing' the dysphoria. Treatment alternatives such as those offered in other countries are completely lacking in Germany.
Parents sound the alarm: The safety of our teenagers is at risk!
ESCAP Declaration
The European Society for Child and Adolescent Psychiatry (ESCAP) publishes its statement on the care of children and adolescents with gender dysphoria: There is an urgent need for safeguarding clinical, scientific, and ethical standards.
Professors criticise the S2k draft guideline
14 German professors of child and adolescent psychiatry publish a Joint commentary on the current draft of the new S2k guideline "Gender incongruence and gender dysphoria in childhood and adolescence"
Experts on „Europe and the PB Debate”
What is the "post-Cass" situation in Europe? Stella O'Malley (GB), Riittakerttu Kaltiala (Finland) and Alexander Korte contribute to a
Dr Alexander Korte reports in Emma magazine about the„The situation in Germany is still very confused. We will very soon have the clearly trans-affirmative guidelines which have been revised in recent years under the leadership of the German Society for Child and Adolescent Psychiatry [Psychomatics] and Psychotherapy. But at the same time, there are an increasing number of critical voices pointing to the lack of scientific evidence for the early medical intervention of concrete puberty-blocking treatment."
"They're not picky about who they treat. They know about the risks, but they do it anyway."
Appeal from international parents' organisations
Call from the
Initiative Goodwardens to health authorities and policy makers worldwide to end reliance on WPATH..
Parents protest about the S2k draft guideline
Parents (TTSB, parentsofROGDkids, AMQG) write an open letter to the professional societies and the professional body responsible for drafting medical guidelines (AWMF) calling for a halt to the publication of the WPATH-SOC orientated S2k draft guideline. Instead, the open letter calls for appropriate recommendations based on evidence and the development of knowledge that takes account of all systematic reviews, such as the Cass Review.
Cass review final report
The Cass Review Final Report is published. It includes far-reaching changes in the care of minors who have problems with their sex/gender, such as the abandonment of the so-called "affirmation model" and the associated routine use of puberty blockers and hormones. The evidence base does not support the use of these drastic treatments, nor does the 'affirmation model' do justice to the complexity of teenage health problems. Conclusion of the Final Report:
„For most young people, a medical pathway will not be the best way to manage their gender-related distress.”
Presentation S2k guideline draft
The Draft of the S2k guideline „Gender incongruence and Gender dysphoria in childhood and adolescence: Diagnostic and treatment" for German-speaking Europe is presented at a virtual press briefing.