Medical environment
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The increasingly adopted “gender affirmative” approach harms children and adolescents, as well as young women. The implementation of the “transaffirmative” approach is a public health scandal.
In January 2022, the law was amended to facilitate the procedure to change one’s “legal sex” in the civil status registry by a simple declaration, i.e. self identification, with children under the age of 16 requiring parental approval. This procedure separates biological sex from “legal sex”, creating a legal fiction. In three years, 2500 people went ahead with a legal sex change, the majority being young people under 25 years old, with girls and young women being the largest cohort (Swiss Statistical Office).
From self identification to medical interventions?
The ease of changing one’s “legal sex” followed and possibly amplified the new phenomenon of the growing number of young people who present to one of the five paediatric “gender clinics” in Switzerland, in order to cosmetically transform their bodies to resemble the opposite sex. The World Professional Association of Transgender Health (WPATH)’s “gender affirmative” approach, which is promoted by transactivists, taken by these clinics is based on the child’s or adolescent’s self-identification, or “self-determination”, and the patient’s “own judgement”. The diagnose F64 (gender dysphoria), which allows hormonal and surgical “gender” treatments, is simply made on the basis of the patient’s feeling. It reduces any psychological therapies to a form of coaching. The “coach” is supposed to convey “tolerance and progress” and exclusively focuses on the child’s or adolescent’s “gender dysphoria” – unhappiness or discomfort with their sexed body and/or sex stereotypes – and does not examine other possible reasons for their temporary unease or self-questioning. Anyone who does not agree with the “affirmative approach” is deemed “transphobic” and an advocate of “gender identity conversion therapy”.
The international situation
In 2020, following a systematic review of evidence, Finland announced it would restrict “gender affirming care” for minors. In 2022, following a public uproar in the media and a systematic review of evidence, Sweden followed suit. Since then, various countries have banned or restricted “gender affirming care” for minors, including Norway, Denmark, some US states, and, following the publication of the landmark Hilary Cass Review, the UK.
Hilary Cass Review
2024 saw the publication of the Hilary Cass Review, an independent report commissioned by regarding “gender clinics” for children and young people in the UK. A systematic review of evidence, this extensive document presents a critical view of the “gender affirmative” approach. It states that children and adolescents exploring their identity is a natural process, and observes that the growing number of girls and young women consulting “gender clinics” today is very heterogeneous and has very different needs. For the majority of these patients, a medical intervention may not be the best way to manage their “gender”-related distress.
Some of the young patients have neurodevelopment conditions, including autism spectrum disorder (ASD) and/or attention deficit hyperactivity disorder (ADHD), body dysmorphic disorder (BDD), or mental health disorders, including anxiety, depression, eating disorder, functional neurological disorder, suicidality, self-harm, obsessive-compulsive disorder (OCD), or other psychological needs. Some of them have encountered adverse childhood experiences (Cass Review, 2024, pp. 90-97).
The review estimates that the increase in girls and young women presenting to “gender clinics” has paralleled a recent deterioration of mental health in young people.
Another issue concerning young people presenting to “gender clinics” is that a number of them are same-sex attracted (Cass Review, 2024, pp.118-119). Finnish and British "gender clinics" statistics indicate that an overwhelming majority of their patients were indeed homosexuals or bisexuals (Griffin et al, 2020). The rare data on the cohort of young regretters (also known as detransitioners) point to a similar observation (Vandebusshe, 2022). Whether the desire to identify with the opposite sex comes from a strong fantasy or is rooted in homophobia – under no circumstances should it lead these young people to wanting to irreversibly modify their bodies with experimental drugs and surgeries. Most of them might just grow up to be lesbian, gay or bisexual.
Finally, due to the heterogeneity and the complexity of these young patients and in order to provide the best evidence-based care, it is vital that clinicians take a holistic approach and consider other possible diagnoses, instead of simply focusing on the “gender identity” disorder claimed by the patients.
Puberty blockers’ risks to brain and body
The Hilary Cass Review is also critical of the medical pathways encouraged by the “gender affirming” approach. The administration of puberty blockers in order to slow down the increased production of sex hormones occurring in teenage years, which is essential for psychosexual and other developmental processes, is controversially discussed. Originally, puberty blockers were prescribed in the hope of buying the teenager more time for exploration and decision making, without their body developing in an undesired direction. But “puberty blockers are not buying time to think (…). The vast majority of those who start puberty suppression continue [treatment by taking cross-sex] masculinising/feminising hormones.” (Cass Review, 2024, p.176). The outcomes of this treatment are questionable and also carry risks. First, studies didn’t report any improvement of gender dysphoria before or after receiving puberty suppression. Second, “most guidelines emphasise full reversibility as a justification for their use” (Cass Review, 2024, p.174). The review states that “blocking the release of sex hormones could have a range of unintended and as yet unidentified consequences. (…) Brain maturation may be temporarily or permanently disrupted” (Cass Review, 2024, p.178), and “psychological functioning may also be reduced” (Cass Review, 2024, p.179). In addition, “studies found that bone density is compromised” (Cass Review, 2024, p. 178). Puberty blockers also cause atrophy of genitalia, which remain in a childlike stage, and can result in genital and sexual dysfunction that can be permanent.
“For several [professionals], a reason to use puberty suppression was the fear of increased suicidality in untreated adolescents with gender dysphoria” (Cass Review, 2024, p.174). Furthermore, “it is well established that children and young people with gender dysphoria are at an increased risk of suicide, but suicide risk appears to be comparable to other young people with a similar range of mental health and psychosocial challenges” (Cass Review, 2024, p.186). “The evidence does not (…) support the claim that gender-affirming treatment reduces suicide risk” (Cass Review, 2024, p.187). Moreover, thankfully, “death by suicide in children and young people are relatively rare events, compared to adult suicide” (Cass Review, 2024, p.95).
Taking masculinising/feminising hormones “is not without long-term problems and side-effects” (Cass Review, 2024, p.182). However, the review admits that “there is a lack of high-quality research assessing the outcomes of hormone interventions in adolescents” (Cass Review, 2024, p.184).
Young patient’s informed consent?
The “gender-affirming” approach is based on the principle of “informed consent”. However, the Hilary Cass Review states that informed consent is very challenging. “The large number of unknowns regarding the risk/benefits (…) and the lack of information to help [the patients] make decisions present a major problem in obtaining informed consent” (Cass Review, 2024, p.196). The review underlines the responsibility of the “doctors (…) for any prescriptions they provide and [their accountability] for their decisions and actions when supplying or administering medicines. This could (…) apply to any advice ranging from social transition to hormone treatments” (Cass Review, 2024, p.193).
Social transition: an active intervention
Social transition, which means living as the opposite sex and includes a name change and/or use of different pronouns, is “an active intervention because it may have significant effects (…) in terms of [the patient’s]psychological functioning and longer-term outcomes” (Cass Review, 2024, p.158). The review concludes that “there remain many unknowns about the impact of social transition and that there is no clear evidence that social transition in childhood has positive or negative mental health outcomes”, and adds that “the majority of children who had socially transitioned went on to progress to medical interventions” (Cass Review, 2024, p.162).
The majority of detransitioners are females
The review admits that there is no reliable way to accurately predict which young people might benefit from a medical intervention, and which ones might benefit from alternative pathways. There are numerous people who regret having undergone medical or surgical treatments and wish to return to living as their biological sex. This process is sometimes named “detransition” or “desisting”. “Estimates of the percentage of individuals who (…) have regrets or detransition are hard to determine” (Cass Review, 2024, p.188). It is noteworthy that the majority of detransitioners are female. This shows that most of the girls and young women presenting to gender clinics should not undertake a medical pathway. In Switzerland, at least four prominent cases of detransitioners have been made public: those of Lyo Kessler and Janick in the French-speaking part of the country, and of Chris (Nadia) Brönnimann, and Meli in the German-speaking part.
Mutilation at a very young age
We do not know how many young people are on puberty blockers or take masculinising/feminising hormones in Switzerland, which is quite surprising in this era of digital media. The only official existing data concerns irreversible “gender” surgeries, such as elective mastectomies (the surgical amputation of one’s healthy breasts). These amputations are also being undertaken on minors – 10 girls under 15 years old underwent an elective double mastectomy between 2018 and 2021! In 2023, there were 32 girls under 18, and at least one younger than 15. Since 2016, the number of women under 25 years old undergoing mastectomies has been growing at an alarming rate. Young adults of both sexes are also undergoing irreversible experimental genital amputation/plastic reconstruction in ever growing numbers (Swiss Statistical Office).
The Hilary Cass Review asserts that “brain development maturation continues into a person’s mid-20s. (…) Priorities and experiences through this period are likely to change” (Cass Review, 2024, p.193). “Many clinicians (…) are unable to reliably predict which children/young people will [benefit from medical intervention]and which might regret or detransition at a later date” (Cass Review, 2024, p.194).
Since the publication of the Cass Review, WPATH has been discredited through US court cases, revealing damning internal documentations. Medical professionals, whistleblowers, detransitioners and parents started to successfully campaign to expose the danger behind “gender affirmative care” for minors. The produced an excellent report of the current situation around the world.
In Switzerland, disregarding the Cass Review’s findings, the published a “gender affirmative” position paper on the treatment of minors at the end of 2024. The German AWMF came out in 2025 with new “gender-affirmative” guidelines for minors, which serve as a reference in Switzerland. In July 2025, pressured by parents, Zurich’s Health Services conducted a study and a judicial review, and a motion to ban “gender” surgeries for minors has been filed on a Federal level.
Femina Helvetica demands that public authorities address this pressing issue. We demand that medical professionals offer a holistic approach to young people presenting to “gender clinics”, and collect and publish data, research and follow-up studies regarding these patients.
Femina Helvetica would like medical professionals to respect the precautionary principle “First, do no harm”. We are in favour of evidence-based medicine that serves the individual. Femina Helvetica is against talking girls and boys into thinking that they are “born in the wrong body”. We are against the instrumentalisation and pathologisation of human beings, and the sterilisation, medical experimentation and mutilation of children and adolescents who are confused about their sexed bodies.
Links to supporting documentation of this issue.
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Number of legal sex change in Swiss civil registry in the years 2022-2024 https://www.bfs.admin.ch/bfs/de/home/statistiken/bevoelkerung/stand-entwicklung/geschlecht.assetdetail.35687820.html
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Hilary Cass Review, 2024
https://webarchive.nationalarchives.gov.uk/ukgwa/20250310143642/https://cass.independent-review.uk/ -
RTS article on the strong increase of girls under 18 in psychiatric hospitalization, 2025 https://www.rts.ch/info/suisse/2025/article/hausse-inquietante-des-rentes-ai-chez-les-jeunes-suisses-de-moins-de-25-ans-28857204.html
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Lyo Kessler on Substack of Femelliste, February 2025
https://www.youtube.com/watch?v=2SG3XE2kHA8 -
Chris/Nadia Brönimann on swissinfo.ch, December 2024
https://www.swissinfo.ch/ger/identitaten/detrans-nadia-brönimann-schweizer-trans-frau-will-keine-frau-mehr-sein/88468150 -
Swiss Statistical Office stating that most of surgeries concern girls and young women, 2019-202
https://www.bfs.admin.ch/news/fr/2023-0183 -
Griffin et al, 2020 Sex and Gender Identity, a Re-evaluation of the evidence
https://www.cambridge.org/core/journals/bjpsych-bulletin/article/sex-gender-and-gender-identity-a-reevaluation-of-the-evidence/76A3DC54F3BD91E8D631B93397698B1A -
Vandebusshe 2022, Bedarf und Unterstützung im Zusammenhang mit der Detransition
https://pubmed.ncbi.nlm.nih.gov/33929297/ -
Meli on SRF, Januar 2024
https://www.srf.ch/news/gesellschaft/transgender-trans-op-wie-aus-meli-andre-wurde-und-wieder-meli -
Janick Christen on Femelliste
https://youtu.be/wfZKXHZxMCE?feature=shared -
WPATH files
https://environmentalprogress.org/big-news/wpath-files -
Swiss association AMQG-AUFG for parents of children with "gender" issues
https://www.amqg.ch