Leor Sapir - Is Oregon fast-tracking kids into irreversible treatment?

 Oregon has some of the nation's highest rates of minors receiving puberty blockers and cross-sex hormones. What does the data actually show, and are state policies driving those numbers? Leor Sapir is a Senior Fellow at the Manhattan Institute. He joins the show to discuss Oregon's approach to youth gender medicine, new research findings, and the legal and medical questions surrounding these treatments. 

Transcript

SPEAKER_00 0:02

Welcome back to the Lars Larson Show. It's a pleasure to be with you all across America to a greater or lesser degree, and despite the best efforts of President Trump, you've seen a lot of states that have decided to allow the medical mutilation of teenage boys and girls. And for the longest time, we were told by folks in medicine, oh no, we don't do that. We only do that with adults. Well, no, they're actually doing it with kids. And there are some places in America that stand out as dramatically different in that and not in a good way. And I read this great piece over the weekend written by Leora Sapir, who is a senior fellow at the Manhattan Institute, writing its City Journal. Ms. Sapir, welcome to the program.

SPEAKER_01 0:42

Thanks for having me, Larry.

SPEAKER_00 0:44

So tell me about this study that was just published in Research Connections about where the highest, some of the highest rates of puberty blockers and hormones are being used on children.

SPEAKER_01 0:56

The study was published in May in a journal called Research Connections, and it was actually done by a group group of researchers who are strong supporters, apparently, of these medical protocols in children. And it found that the rates of diagnosis and medical uptake, specifically of puberty-blocking drugs and cross-sex hormones in adolescents in Oregon, because their data looked exclusively at Oregon, were very high, and in fact, higher than the rest of the country. There was a study that was published in 2025 that found that one in 1,017-year-olds was already on cross-sex hormones, which is a shockingly high statistic when you know the history of this area of medicine, where it was, you know, this is a condition found in a tiny, tiny percentage of mostly adult men. But the study from Oregon found that there were several times higher even than that. So it's one in 250 girls in uh in the state of Oregon and one hundred and one in one sorry, one in six hundred and thirty boys are on cross-sex hormones at age 17.

SPEAKER_00 1:58

Well, you also cited that one in every 65 adolescent girls is a potential candidate for medical sex reassignment. That's that's even more stunning, isn't it?

SPEAKER_01 2:09

That's correct. So they found 1.51%, which is about one in every 65 uh teenage girls in the state of Oregon, had what they classify as a transgender-related clinical diagnosis. Um, and as soon as you get that diagnosis, according to Oregon's own standard of care, its Medicaid coverage decisions and the policies of pretty much every commercial insurer in the state, if you have that diagnosis, the only thing standing between you and actually getting the hormones or surgeries is the patient's own desire, meaning if the kid wants it, the kid is going to get it.

SPEAKER_00 2:53

How do they get to that with a 14 or a 15-year-old girl or boy? Do you know do you have any idea?

SPEAKER_01 2:59

Yeah, look, I mean, this is a very long and complicated story, but you know, I think one of the most important factors that people need to understand is something that I've been calling the broken chain of trust. Um and what happened with that this protocol came from the Netherlands. It was developed there in the 1990s and it spread internationally during the 2000s. The first pediatric gender clinic opened in Boston in the United States in 2007, and now we have over a hundred of them. Um, but what's important here is that leaders within the medical field, so medical association leaders, hospital executives, and so forth, um, trusted their colleagues, specifically those colleagues who were kind of more ideologically driven and deeply believed in these protocols. And they trusted them. They trusted that they were looking at the science, they trusted them that they knew the history, they trusted that they were being very cautious and rigorous, and that trust was exploited and was abused. Um, other countries, especially in Western Europe, the most progressive countries in the world, have already awakened to this to this problem and they have imposed severe restrictions. And in the case of UK, they've actually banned puberty blockers for kids. Um but here in the United States, especially in the blue states, because almost all red states have banned these procedures now in kids, but in blue states, places like Oregon, not only are they legal, um, but as we you know, we document in these articles, uh, there's a fast track to the clinic.

SPEAKER_00 4:17

Leore, it sounds like you've followed this story almost as uh as closely as I have, because I've followed it for years. Haven't there been some solid studies out of Western Europe that essentially say, not in medical terms, but they say kids for the most part grow out of this. That if they've decided at 14 or 15, I'm a I was born a girl, but I'm now I'm a boy, or I was a boy and now I'm a girl, that if you wait a couple of years, they decide, yeah, you know what, I was mistaken, and and I'm not actually a girl or a boy, and they go right back to where they were to begin with. Is that not the case?

SPEAKER_01 4:52

That's close to the case. So we have about five decades of research showing that in children, meaning before puberty, children who experience confusion about their sex, the vast majority grow out of it, and actually most of them turn out to be gay, which means that you know uh severe gender nonconformity in childhood is closely associated with homosexuality, but not at all with adult transsexuality. Um the question is a little bit different when you're talking about teenagers, and there the advocates of these medical procedures initially hypothesized that you know, if a kid uh emerges into puberty and still has these feelings, they're gonna have them for the rest of their life. That was never tested. It was just a theory. Um, and in fact, we do have now some emerging evidence from uh from the Netherlands, from uh from the United States, that actually a majority, even of teenagers who experience these feelings, eventually desist from them and come to terms with their sex. But look, even if they don't desist from them, uh, you know, you're asking 12, 13-year-old kids to, you know, give up their future fertility and sexual function, um, you know, even if they're they're destined to have these feelings as uh in adulthood, and we don't know that they are, but even if, um, I think there's severe ethical problems with letting them consent to these invasive procedures.

SPEAKER_00 6:08

Aaron Powell, I'd agree with you. And and even if, I mean, let's say you've got a 14 or 15-year-old girl or boy, even if they never do the surgery top or bottom or otherwise, but if they're only doing the hormones, isn't that likely to produce in many cases lifelong changes that you can't undo?

SPEAKER_01 6:25

That's correct. So uh in boys in particular, if they do the entire uh uh hormonal protocol as intended, what's called the Dutch protocol, where they start puberty blockers at tanner stage two, that's the very beginning of puberty, and then they go on to cross-ex hormones, that's the intended protocol. They will be sterile because their gametes will never have a chance to mature. Um, for girls, there's a high expectation of negative fertility impacts, but we don't really know if those are reversible. Um, and there are many other harms that we, you know, have first of all, the harms have not really been studied because the people who are doing the research are usually gender clinicians who strongly believe in these interventions, and for the most part, they have not wanted to look at harms. But there are some studies on harms, and the evidence is emerging, and we know that sexual dysfunction is a harm, um, cardiovascular impacts, um, cancer, potential for cancer, cognitive impacts. There's a um a possibility for reduced IQ. So there are real consequences to these drugs, um, and they're being given to teenagers mostly on the basis of the, you know, whether the kids want them or not.

SPEAKER_00 7:31

You know, this is really disturbing. Layor, I'm gonna highly recommend that my audience go out and read your piece at City Journal. I thought it was an excellent piece. I read it over the weekend, and I appreciate your willingness to come on and talk about some of the results.

SPEAKER_01 7:44

Thanks for having me, Lars. I appreciate it.

SPEAKER_00 7:46

I'm glad to have you on. That's Lior Sapir, who writes for City Journal. He's a senior fellow at the Manhattan Institute, and this is what's really disturbing the confirmation bias he talked about, where the doctors who actually believe in this stuff say, we're the ones who are going to study, and if there's a problem, we'll let you know. Only they already believe in it, which means their likelihood of finding a problem is pretty low. Back in a moment. Glad to get your calls. 866, hey Lars. You got the Lars Larson show.