Under a recently elected conservative government, opposition lawmakers are saying Portugal is backsliding on LGBTQ+ rights with a set of three new measures that erase several advances under the country’s previous Socialist governments.
On Friday, Parliament took a step toward approving the repeal of a 2018 law that enshrines a right to gender self-determination and the protection of individual sex characteristics. It was one of the most far-reaching laws of its kind when it was introduced in its original form in 2011.
Three bills to amend the law were advanced by a far-right conservative coalition that now holds a controlling majority in Portugal’s Parliament.
Among other provisions, the repeal of the original law would reinstate a requirement for “medical validation” for anyone changing their name and gender in the country’s civil registry, Euronews reports.
Those changes are currently possible for any citizen without a medical certificate. 16- to 18-year-olds only need parental authorization and a report from a health professional attesting to their “capacity for decision-making and informed will.” The amended law would again require the approval of a “certified” medical board.
According to language in the new proposal, a report that “proves the diagnosis of gender incongruence” must be prepared by a specialized multidisciplinary clinical team in a public or private health establishment and must be signed by at least one specialist physician and one specialist psychologist.
Portugal’s government has seen a tilt toward the right over the last several years. In 2024, a center-right coalition called the Democratic Alliance won a plurality of seats in legislative elections, ending eight years of Socialist rule. Prime Minister Luís Montenegro won a renewed mandate in a snap election on May 18, 2025, again forming a minority government. In the meantime, the far-right nationalist, anti-immigrant Chega party has become the main opposition party in the 230-seat Parliament.
A proposal from that party also revokes the current legislation but introduces new articles for the “protection of children and young people,” including a ban on the inclusion of “gender ideology” in education curricula for minors. “Education in this field is reserved exclusively for parents or legal guardians,” the proposal reads.
Another far-right party coalition introduced a measure that “protects the integrity of children” by banning puberty blockers and/or hormone therapy in the treatment of gender dysphoria for trans youth.
“A man is a man, and a woman is a woman,” declared Madalena Cordeiro, a Chega member of Parliament. “The differences between them are clear and evident. It’s 9th-grade science. Now, all it takes is one consultation for a child to be diagnosed with gender dysphoria in five minutes.”
“It’s not care, it’s not medicine, it’s not science,” he claimed.
On the left, Livre party member Filipa Pinto questioned right-wing members over their previous opposition to marriage equality. Would they feel “comfortable about once again being on the wrong side of history, as they were when same-sex marriage was approved?” she asked.
“What wrong have trans and intersex people done to deserve being denied their existence?”
“There is no single reason for these changes, other than ideological obsession,” said another Livre member, Paulo Muacho, who asserted that trans people don’t need to be diagnosed by anyone, because being trans isn’t an illness.
“They don’t need doctors to tell them,” he said.
Socialist Party deputy Isabel Moreira lamented the turn in the tide away from democratic freedoms with the ascension of Chega and their allies.
“Fifteen years after the 2011 law” was passed, she said, “three parties in this house claim that transgender people should not have the autonomy to express their identity.”
“Democracy is being destroyed,” she said. “The playbook is well-known, and it comes from the far-right.”
Iceland, birthplace of the literary tradition of the saga, is a nation of just 390,000 people. It is renowned for its progressive values: peace, wellbeing and human rights. At present, however, this small island is home to a monumental division.
After a chequered history with lesbian and gay rights, things looked positive when the country legalised same-sex marriage in 2010. But having achieved its aims, the gay rights movement turned to genderism. And this is now having serious consequences for anyone who refuses to believe that it is safe (or indeed possible) to change sex.
I arrive in the capital city of Reykjavik on a freezing February morning, and meet with Eldur Smári Kristinsson at the end of an hour’s drive through lava fields. As the international liaison for LGB Alliance Iceland – a group of about 10 women and men keen to prioritise same-sex rights over gender identity – he is keen to discuss the ideological capture of the nation he refers to as “Gender Gilead” [a reference to the dystopian regime in Margaret Atwood’s novel The Handmaid’s Tale].
Kristinsson is tall, smartly turned out, and would not look out of place in a university lecture theatre. Proudly gay, he travels far and wide, speaking at conferences on the harms of transitioning gender-nonconforming children. “Who knows if these kids would end up being lesbian or gay? But even if they don’t, we should allow children to play with the toys they wish to, and not tie them to sex stereotypes,” he says.
He is currently under police investigation for alleged hate speech in three posts on X, one of which criticises men taking the medication domperidone to induce lactation and “breastfeed” infants. “I am facing two years in prison,” he tells me, “for speaking out about child safeguarding.” It was the LGBT organisation Samtökin ’78 (originally the Lesbian and Gay Association of Iceland) that reported him to police.
My mission is to establish whether Iceland has, as Kristinsson claims, signed up to the most extreme version of transgender ideology on the planet, and whether or not it could come to pass in Britain, bearing in mind the level of pushback from feminists here, which resulted in the Supreme Court ruling in April 2025 that references to “sex”, “man” and “woman” refer to biological sex only.
At my hotel in central Reykjavik, I meet a number of Kristinsson’s allies – all of whom have encountered hostility and social exclusion for speaking out. Anna*, a 40-year-old lesbian who teaches at a primary school in northern Iceland, tells me: “Iceland is, without a doubt, the most captured country in terms of trans madness.”
Like Kristinsson, Anna is a member of LGB Alliance Iceland. As things stand, she says, schools tell young children they can change sex, which confuses and distresses them.
The 2010 marriage equality law plunged the Lesbian and Gay Association of Iceland into an existential crisis which culminated with its rebranding – as the National Queer Organisation of Iceland (Samtökin ’78) – and expanded its agenda to include the “trans child”.
A further controversial decision came in 2015, when Samtökin ’78 classified BDSM (bondage, discipline and sadomasochism) as a sexual orientation. It also partnered with Reykjavik city council to produce sex education posters for schools which promoted both BDSM and multiple-partner relationships to children as young as five.
Four years later, following lobbying by Samtökin ’78 and others, the Gender Autonomy Act was introduced, making it possible for anyone over the age of 15 to self-identify as the opposite sex, without requiring medical, psychiatric or judicial approval. This extends to name changes on all legal documents, including birth certificates.
Freyja* is a legal scholar, based in neighbouring Norway, who attempted to meet with Icelandic lawyers to advise on how the law might be halted on the grounds that it flouted international human rights treaties. She says the laws were introduced “almost secretly – there was barely any consultation with the general public, and it appeared to be a stitch-up between Samtökin ’78 and the government”.
Kristinsson tells me that this change in the law led to an exponential surge in numbers of “trans children”, most of whom were young girls from upper-class backgrounds, many of them under the “neurodivergence” umbrella. The statistics bear him out; by 2025, 0.5 per cent of Icelandic children had changed their sex markers with the National Registry – approximately 13 times the per-capita rate of neighbouring Denmark.
As the only country in the World Economic Forum to have eliminated more than 90 per cent of wage and opportunity inequality, Iceland is proud of its record on gender equality. Women now hold 48 per cent of seats in Iceland’s parliament, and comprise 60 per cent of its law students.
Iceland is often classed as the best country in the world in which to be a woman, yet those hard-won rights are being given away in the name of trans inclusion; Icelandic feminists have caved in to bullying and gaslighting.
This former beacon of gender equality has become a totalitarian regime, and the top-down ideological capture is affecting children, institutions and society at large – with chilling implications.
The children’s ombudsman, Salvör Nordal, grants me an interview. When I ask whether she has come across the issue of children wishing to identify as the opposite sex, she tells me that, post-Covid, her office has seen a significant decrease in interest and lobbying relating to gender identity and the trans issue.
Citing a national Icelandic medical survey, she says: “There was a group of children that were one third maybe with autism, one third truly trans, and one third with some other complication or other.
“It has been two or three years since this issue was on my desk,” she adds. Back then, she says, there were parents of three- and four-year-olds who were claiming to have a trans child. “And they had changed their names. So, we were concerned about that.”
Nordal’s comment about survey data showing that some children are “truly trans” leads me to ask whether, in her opinion, trans children exist, in that they are trapped in the wrong body? “It’s not my role to decide,” she says, explaining that her job is to think about children’s rights, rather than to have opinions about medical or psychological issues. “We have other professionals to do that. I focus on what is important for my job. We need to listen to children. This is a very difficult track to take.”
Icelandic law also recognises the sex changes of foreign visitors. In 2025, a trans “refugee” from the United States turned up in Iceland, attempting to claim asylum. “Alexandra” (a “stay-at-home mother”) claimed to be fleeing anti-trans persecution in Minnesota. His claim was not upheld. After Alexandra was told by police to go to the US Embassy in Iceland for help, his appointed spokesman said it was like “deporting Afghan women to the Taliban”.
My earlier trips to Iceland were to speak at conferences on male violence, organised by Stígamót, a well-known women’s organisation. But when I attempted to make contact with old friends in the feminist world, I was either ghosted or subjected to lecturing about “inclusivity” and “trans rights”. Even the hard-line feminists have capitulated – including those previously brave enough to take on pimps and pornographers.
In 2020, lesbian singer-songwriter Iva Marín Adrichem sang in the national final of the Eurovision Song Contest. Born blind, she had been included – as a high-profile Icelander – in an Icelandic tourist board film to encourage more disabled visitors to the country.
“I was cut out of the film because someone made a fuss about my views on gender,” she tells me when we have lunch together in Reykjavik, “ironically, in the name of diversity and inclusion.”
The trans trend spreads from the elite: both the bishop of Iceland and the rector of the Iceland Academy of the Arts have spoken proudly of being mothers to “trans children”.
The head of transgender medicine at Iceland’s state hospital is Asa Radix, a Canadian living in Iceland, who was appointed in 2025. Radix is also the president of WPATH, the World Professional Association for Transgender Health. WPATH was exposed by investigative journalists as a group of trans rights activists whose practice raises significant questions about the nature of gender-affirming care and the evidence base for WPATH’s widely followed guidelines.
Iceland’s reputation in transgender healthcare is seen by other countries with self-ID laws, and those looking to establish them, as a gold standard model. In 2025, Mary Butler, junior health minister for mental health in Ireland, travelled to Iceland to take part in a “knowledge exchange” project organised by the Icelandic ministry for health. The Irish delegation met with gender clinicians and people with “lived experience” of gender medicine. The official purpose of that visit was to inform the development of the new model for gender healthcare in Ireland.
Iceland’s national flag is fast being replaced by the “Progress flag” – on churches, schools, government buildings and police stations. And the fact that rainbows painted on road surfaces are commonplace, even in tiny villages with fewer than 200 residents, signals a quasi-religious reformation: the teachings of postmodernist theorists Michel Foucault and Judith Butler have supplanted those of Jesus Christ.
The headquarters of the bishop of Iceland is in a purpose-built building in Reykjavik’s centre. I cold-call, hoping to catch Gudrún Karls Helgudóttir, who has been outspoken in support of her own trans-identified child and her commitment to the LGBT community. The church once ran an advertisement campaign featuring a trans Jesus Christ, complete with breasts, on Reykjavik’s buses.
Helgudóttir is unavailable, but her secretary, Eva Björk Valdimarsdóttir, invites me into a space generously adorned with pride, progress and trans flags, as well as an ornament of the drag act RuPaul. Valdimarsdóttir is a “big fan” of Drag Race.
When I ask how the Icelandic church became so focused on the inclusion of LGBT people, she explains that both the former bishop and the church had poor reputations as a result of having denied equal marriage rights to lesbians and gay men, and wanted to compensate for this stain on the church’s history. She says that the Bible, if read properly, does not pour scorn on same-sex couples, and that it is not God’s will to deny same-sex people who love each other to marry. “God does not discriminate,” she says.
Next, I ask about child safeguarding – for example, if a trans-identified man were to accompany children on a church trip. As a “trans woman”, would he be assigned to the girls’ sleeping quarters? “Those people are valid and their identities are valid,” she tells me. We go back to the Bible and what Jesus said. “He especially stood with marginalised people.”
I ask her whether God ever makes mistakes, and whether a child can be born in the wrong body. Before answering, she wants to make sure it will be specified that this is only her opinion. “There are not just two sexes, male and female. It is not that simple.”
How does that work, though, for children who want to be medicalised? “They have a long waiting list, then they have their specialists. I don’t think the church needs to decide anything for them.”
At this stage, Valdimarsdóttir asks if she can speak personally, rather than in her role as secretary to the bishop. She says trans women are as trustworthy as “cis” (biological) women, and that some people are “in between” male and female.
I ask, can a baby be born in the “wrong body”? “Should that child not live?” she replies. “And is this child not perfect as they are also in their minds and in their spirit, in what they say they are?”
Reykjavik-based father Alexandre Da Rocha meets me for coffee to talk about the conflict between him and his former partner over their son. When the child came home from school saying he wanted to be a girl, and was affirmed by his mother, Da Rocha made it clear that he disagreed, resulting in the case being referred to the family court by the mother. In November last year, the court decided that the boy’s mother would have sole custody, having previously shared it with the father.
“In the judgment, it was made clear that I am a good father, a good parent, and that there was no question over that. It is, I am certain of it, because I have refused to affirm my son as a girl,” Da Rocha says.
His lawyer, Hilmar Gardars Thorsteinsson, tells me that the problem in such cases, where one parent is in dispute with the other over children who wish to change sex, is halting the process before the prescribing of puberty blockers.
“It is almost always affirmed by teachers, for example, and then they are recommended to get puberty blockers at around 11 or 12,” he says. “I don’t know exactly the number, but I think it’s around 100 kids under 18 undergoing something like this.”
The following morning, I head to Laugardalslaug swimming baths, one of many across the city. Swimming is sacred to Icelandic people and a big part of their culture. The rules are strict: you are not allowed into the water until you have thoroughly showered. There are posters of stick figures on the walls with arrows pointing towards the armpits and genitalia. How will this work with “trans women” using the female showers, I wonder?
After explaining my purpose in visiting Iceland, I have a conversation with a young, muscle-bound man who works there. “Do you have single-sex communal showers?” I ask. “Yes,” he replies, “there are female showers and male showers.”
“But if I said I was a trans man, would I be allowed to go and shower in the men’s shower room?” His female colleague answers: “The communal showers are not single-sex but you can ask for a private cubicle if you wish.”
I seek clarification: “So are there no single-sex facilities at all?” This question is met with bafflement, so I try again. “Do any women ever ask for the mixed facilities?”
“No,” comes the response.
Ina Steinke has travelled a considerable distance across Iceland to meet with me. She got to know Kristinsson and the others speaking out because she hates the idea that the right to free speech is under threat. After our visit to the swimming pool, she appears angry at what she heard.
“There’s not even a warning,” says Steinke.“Being at risk of seeing a naked man in the women’s showers is this new reality. In our culture, it’s not an issue to be naked in front of other women, it’s part of our heritage. Also, sex offences – it’s nothing new to Icelandic people, but now, we can’t complain about the naked man; we can’t point out the sex of the person that rapes you.”
My final stop before leaving Reykjavik is to the mayoral hustings, where Ari Edwald, the candidate for the socially conservative Midflokkurinn (“Centre”) party, is due to give a speech. During the Q&A, I ask what he would do, if elected, to end the inclusion of gender ideology in schools. His is the only party to have spoken out against gender ideology and its effects on children.
School should not be a place of indoctrination, he responds, adding that contested ideas from sociologists and queer theorists in universities should not be taught as fact. If elected, he will do his part to wind this nonsense up.
With the help of lawyers, LGB Alliance Iceland is preparing various legal routes to challenging transgender practices against Icelandic youth. It is also looking at how to reverse so-called “conversion therapy” legislation, which would effectively criminalise any therapist or counsellor that doesn’t affirm a child presenting as transgender.
Da Rocha, the father desperately trying to stop his child from starting on a path towards changing his sex, is appealing the decision of the family court to deny him joint custody of his son. “If he decided to be gay when he grows up, then fine,” he tells me, but to do something he can never reverse would be terrible for him.”
Meanwhile, Kristinsson is keen to find out what is happening with his criminal case, as it has been several months since he was charged with hate crime offences. I accompany him to the main police station in Reykjavik.
Article 233A of the penal code forbids ridicule, slander and hatred towards those with protected characteristics: in this case, trans-identified people. As he awaits his turn at the security screen, he tells me: “I have the legal label of ‘criminal suspect.’”
“We’ve been looking for you,” says a uniformed officer when she finally appears. “You need to come back and be interrogated for another crime, on Friday.”
The American Medical Association (AMA) reaffirmed its support for gender-affirming care and said media outlets that reported a change in its policy (including LGBTQ Nation) misinterpreted a recent statement from the organization.
AMA’s March 2026 newsletter devoted a section to the debacle and explained that it all started in February when Dr. Mehmet Oz, the head of the Centers for Medicare and Medicaid Services, held a meeting for the leaders of the nation’s major medical organizations to discuss why they all endorsed medical interventions for trans teenagers.
Sources told the Times that Dr. Oz’s tone was measured, rather than hostile, but that it was clear he hoped to sway the organizations away from supporting gender-affirming care for young trans people. At the meeting, the American Society of Plastic Surgeons (ASPS) reportedly shocked everyone by announcing it was indeed changing its stance on gender-affirming care.
The ASPS announced the change in its stance publicly on February 3, releasing a statement advising against conducting “gender-related breast/chest, genital, and facial surgery” on people under the age of 19. The ASPS based its statement on two recent reports from the U.K. and the U.S. that were widely criticized by transgender healthcare advocates as being biased.
Surgical interventions, however, are already almost never performed on minors. Trans minors don’t receive bottom surgery, though some teenagers who meet certain rigid requirements get top surgery or facial procedures.
The AMA newsletter explained that once ASPS released its statement, the AMA’s Executive Committee of the Board met to craft a statement to provide to probing media outlets.
“During our Board discussion, we were clear that we were not changing AMA policy,” the newsletter said, emphasizing that the statement was exclusively to be used if media outlets contacted the organization, rather than preemptively.
“While some media coverage characterized this as agreement with the ASPS statement, that phrasing did not come from the AMA,” the newsletter continued. “Unfortunately, how reporters frame their stories is beyond our control.”
The newsletter emphasized that the statement did not reflect a policy change or an endorsement of ASPS’s policy change: “AMA policy on gender-affirming care is unchanged. Our recent response to questions about ASPS’s position statement was intended to preserve—not diminish—access to gender-affirming care, and to clarify and reinforce what our policy has long reflected and standards of care. The AMA supports gender-affirming care as medically necessary per our policy.”
The language in AMA’s initial statement sowed chaos because it does state: “In the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”
But because gender-affirming surgery is already rare for minors, it seems AMA is trying to say it was merely reaffirming the position it has always held, which is that it supports non-surgical interventions for minors and, in rare cases, surgical ones.
At the time the ASPS walked back support for gender-affirming care, and many at least believed AMA did, too, the American Academy of Pediatrics (AAP) released its own statement emphasizing it still fully endorses gender-affirming care. “The AAP continues to hold to the principle that patients, their families and their physicians — not politicians — should be the ones to make decisions together about what care is best for them,” the statement read, according to the New York Times.
The World Professional Association for Transgender Health (WPATH) also spoke out: “There is no definitive age or one-size-fits-all approach for every patient, which is why they are built on case-by-case assessments, involve experts on adolescent development, and are designed to support thoughtful and ethical shared decision-making in a multidisciplinary field.”
Recent studies have shown that trans youth tend to be consistent in their identities, even after a decade. The findings mirror what has overwhelmingly been found in studies on trans adults, that very few people detransition. A 2024 study found that 97% of trans youth don’t regret transitioning, and another study from the same year showed that fewer than 1% of patients who undergo gender-affirming surgical procedures end up regretting it. In fact, rates of regret are higher for people who get tattoos, elective plastic surgeries, bariatric weight loss surgeries, or have children, the study found.
South Dakota Gov. Larry Rhoden (R) signed two anti-trans bills into law on Friday, touting them as “South Dakota values bills.” In a press release announcing the signings, Rhoden proclaimed that “South Dakota has always stood for truth.”
“My Administration will continue to uphold the values that make our state strong, safe, and free,” he added. “These bills reflect our commitment to carry those values forward for future generations.”
The two anti-trans bills – HB 1184 and HB 1161 – respectively ban legal recognition of trans identities and require people in the state to use facilities like bathrooms and locker rooms based exclusively on sex assigned at birth.
Also on Friday, Rhoden signed three bills rolling back reproductive rights in the state. In a statement, he called South Dakota “the most pro-life state in America” with laws that “reflect the fact that an unborn child is a person – and that child is worthy of our protection and respect.”
Artemis T. Douglas of the pro-trans publication The Needle, called the slew of bills a “show of force for reactionary patriarchy’s anti-trans political movement.”
“Anti-trans politics protects social control,” Douglas added, “including men’s position in the gender hierarchy and the status of everyone else as either property or incubator.”
South Dakota has long been a hostile state for LGBTQ+ people. The Movement Advancement Project gave it an overall ranking of -9.5/49 on LGBTQ+ rights, with a -9/26 for trans rights, specifically.
The state bans trans students from playing on sports teams consistent with their gender identity and also bans gender-affirming care for trans youth. It bans changing gender markers on birth certificates and also has no statewide nondiscrimination laws in place for gender identity or sexual orientation.
Trans Kansans are reportedly leaving the US state in droves after thousands had their driving licences forcibly revoked.
The midwestern state revoked more than 1,700 IDs this month after handing letters to thousands of citizens demanding they surrender their driving licences.
It comes after lawmakers passed SB244, a sweeping anti-trans bill banning Kansans from using public toilets and locker rooms consistent with their gender identity. The bill also allows resident to submit bounty-style lawsuits against anyone they spot in facilities who they believe are transgender or non-binary.
Trans people in Kansas could face up to six months in jail if they don’t surrender their IDs. (Getty)
In response, the Kansas Division of Vehicles informed trans residents that their licences were now “invalid immediately” and must be exchanged for new licences documenting their birth sex.
Those who continue to drive without surrendering the licences could face “additional penalties”, including a $1,000 fine or even imprisonment.
Trans Kansan Jaelynn Abegg, who received a letter demanding her licence be revoked, said she plans to move to another state later this month and refuses to surrender her ID.
“I’m pretty heartbroken,” the 41-year-old told NBC News. “It is a continuation of the message that the Legislature has been sending out for years now, and that is that transgender people are not welcome in Kansas.”
Another woman, Andrea Ellis, said that, upon travelling to the DMV to have her licence changed, staff were confused over what to do, eventually giving her a temporary license with no changes.
Matthew Neumann, a Kansas-born trans man, said he refuses to leave the state over the legislation despite being threatened for using public toilets.
“I’m just disappointed and frustrated,” he said. “I’m just hoping that maybe this is the wake up call we need.”
Lawmakers passed the widely criticised bill despite governor Laura Kelly vetoing it in February, which was overturned by the Republican majority.
The Democratic governor said the law was “poorly drafted” and that its provisions were ripe for abuse that would have consequences “far beyond the intent to limit the right for trans people to use the appropriate bathroom”.
“[The law] will undoubtedly impact many others who are targeted with animus whether or not they are transgender. Meanwhile, leaders ignore real challenges facing families,” she continued. “This was sadly politics over people, but we will keep fighting for dignity and freedom for all LGBTQ+ people.”
Multiple cases have emerged across the UK and US over the past year, as anti-trans furore over toilet usage has grown louder, with many involving cisgender and transgender individuals.
In August last year, an 18-year-old cisgender lesbian said she was forced to expose her breasts to a staff member in a Buffalo Wild Wings who began banging on the toilet stall she was occupying and yelling that the “man needs to get out of here”.
Two anonymous trans Kansans sued the state over the bill’s passage last month, arguing that it violates human rights laws on autonomy and personal freedoms.
Douglas County District Judge James McCabria declined to grant a temporary restraining order against the law’s enforcement while the case proceeds earlier this week.
Harper Seldin, an attorney for the American Civil Liberties Union (ACLU) representing the plaintiffs said that Kansas was singling out trans residents “for unique social stigma”.
“They were suddenly required, with no notice or opportunity to be heard, to present themselves to the DMV to obtain driver’s licenses that announced to everyone – the teller at the bank, the clerk at the hotel, the poll worker on election day – that they are transgender,” Seldin said.
This week, England’s National Health Service (NHS) threw up yet another roadblock to gender-affirming care for transgender youth in the UK.
On Monday, the NHS announced it was pausing new referrals for feminizing and masculinizing hormones for 16- and 17-year-olds suffering from gender dysphoria, citing a collection of studies commissioned by the health service after publication of the controversial Cass Report in 2024, the Guardian reports.
That study recommended “extreme caution” initiating hormone treatments, including estrogen and testosterone, and a “clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18.”
The new NHS report comes to a similar conclusion.
“Following the Cass review, NHS England commissioned an in-depth review of all available clinical evidence for using estrogen or testosterone either alone or with other medications to treat gender incongruence and dysphoria,” the report states. “This review has established that the available evidence does not support the continued use of masculinizing or feminizing hormones to treat gender incongruence or dysphoria for young people under 18.”
The Cass Review, which contradicted long-established guidance around the efficacy of gender-affirming care for trans youth, has already prompted the health service to halt prescriptions of puberty-suppressing drugs for trans youth, with an indefinite ban for trans minors enacted by the UK government in December 2024.
The UK’s Health Secretary cited an “unacceptable safety risk” for halting new prescriptions of the drugs, though puberty blockers are still prescribed for early onset puberty and other conditions for children not suffering from gender dysphoria.
Puberty blockers, or GnRH analogues, slow down or halt the onset of puberty in young people taking them, and have preceded and been accompanied by the use of estrogen or testosterone for gender transition.
The positive effects of that combination therapy were all but ignored in the new NHS review, say critics of the decision to halt new prescriptions.
The Dutch Protocol, the “gold standard” for transition care, “involves prescribing GnRH analogues (puberty blockers) first to suppress puberty, then adding hormones later,” writes trans journalist Erin Reed in a story questioning the report’s findings.
“When hormones are introduced, the GnRH analogues are sometimes continued alongside them — the blocker keeps suppressing the body’s natural hormones while the prescribed estrogen or testosterone does its work. This overlap period means patients are on both GnRH analogues and hormones at the same time. That is the ‘combination therapy’ the reviews claim to examine.”
But the reviews “inexplicably excluded every study” where GnRH analogues and feminising and masculinising hormones were taken in succession or combination. The review tossed out hundreds of such studies in favour of a “salami slicing” approach that examined the hormones in isolation.
NHS was explicit in its methodology.
“Any reference to GnRH analogues in the context of puberty suppression or used as puberty-suppressing hormones must be excluded,” the report states.
“NHS England’s own data, cited in the reviews themselves, confirms that 98% of its patients followed the very pathway every review was designed to exclude,” Reed writes.
She called the NHS evidence reviews “an extreme example of politically-manufactured science.”
Gender Plus, a leading private trans healthcare and education service in the UK, accused NHS England of ignoring clinical expertise and evidence provided by leaders in the field, including the Endocrine Society, which recommends introducing the hormones for trans youth once “persistence of gender incongruence has been confirmed and the young person has sufficient capacity to consent.”
“NHS England’s interpretation of the evidence is in contrast to every reputable expert body in the field of transgender healthcare,” said a spokesperson for the health group.
NHS said patients currently receiving hormone treatments can continue the therapy, “but this will need to be reviewed individually with their clinical team.”
“Banning new prescriptions of gender-affirming hormones for 16- and 17-year-olds is a profound attack on young people’s bodily autonomy,” said Tammy Hymas, policy lead at British advocacy organization TransActual, “with trans people yet again cruelly singled out by this government.”
In most of New England, the question of whether transgender people may use bathrooms consistent with their gender identity has largely been settled. In New Hampshire, lawmakers are reopening it.
The Republican-controlled New Hampshire House voted 181–164 on Wednesday evening to pass House Bill 1442, legislation that would allow schools, government buildings, and some businesses to restrict bathrooms and locker rooms based on sex assigned at birth rather than gender identity. The bill now heads to the state Senate.
If enacted, the measure would place New Hampshire further out of step with the rest of the Northeast, where protections for trans residents in public accommodations remain broadly intact.
House Bill 1442 would require bathrooms and locker rooms in public schools and municipally owned buildings to be designated for male or female use based on sex. The bill also allows businesses and other places of public accommodation to require that multi-user restrooms be used according to what the legislation defines as a person’s “biological sex.”
The proposal goes further than many similar measures elsewhere by creating a new legal mechanism tied to restroom use. Under the bill, entering an area designated for females while classified as male under the statute could be considered “willful trespass.”
The legislation also establishes a statutory definition of sex that centers on biological characteristics such as chromosomes and reproductive anatomy, stating that a person’s gender identity does not determine access to spaces designated for males or females.
Supporters argue the legislation protects privacy in intimate spaces. Opponents say it singles out transgender people for exclusion and undermines civil rights protections that the state adopted less than a decade ago.
The vote follows several years of legislative attempts to pass similar restrictions, which repeatedly ran into gubernatorial vetoes.
Weeks ago, Gov. Kelly Ayotte, a Republican, vetoed a comparable proposal that would have allowed transgender people to be excluded from bathrooms, locker rooms, jails, and other gender-segregated spaces. It was the third time in as many years that a New Hampshire governor rejected similar legislation.
Ayotte said the earlier proposal was overly broad and risked creating an exclusionary environment.
Her predecessor, Chris Sununu, who is also a Republican, vetoed a similar measure in 2024, writing that lawmakers were attempting to address problems “that have not presented themselves.”
Yet the issue has returned to the legislature year after year.
Advocates say the persistence reflects a broader campaign targeting transgender rights in the state. According to the advocacy group 603 Equality, several bills introduced during the current legislative session attempt to regulate public facilities based on what lawmakers describe as “biological sex,” part of a wider slate of proposals affecting bathrooms, sports participation, and identification documents.
The group says House Bill 1442 is among the most “sweeping and cruel” of those proposals.
In 2018, New Hampshire added gender identity to its nondiscrimination law, becoming the final state in New England to extend those protections. At the time, the move appeared to complete a regional consensus on LGBTQ+ equality.
In recent years, however, that consensus has begun to fracture.
In 2025, Ayotte signed legislation banning gender-affirming medical care such as puberty blockers and hormone therapy for transgender minors, making New Hampshire the first state in New England to enact such a restriction.
Neighboring states, including Massachusetts, Vermont, Rhode Island, and Connecticut, maintain broad protections for transgender residents across public accommodations and health care.
Even Maine, which, like New Hampshire, has long been politically competitive and regularly elects Republicans to statewide office, has not enacted comparable restrictions on transgender rights. Instead, Maine has become the focus of a separate political fight: a proposed ballot measure backed by national conservative donors that would bar transgender girls from school sports and require schools to separate bathrooms and locker rooms based on sex assigned at birth.
Advocates say such policies place transgender people in untenable situations, forcing them to choose between using facilities inconsistent with their gender identity or risking confrontation.
Texas Attorney General and U.S. Senate candidate Ken Paxton (R) is suing a New York-based company for marketing chest binders to minors.
Paxton has accused trans and nonbinary-inclusive youth undergarment brand Lola Olivia of violating his state’s consumer protection laws banning false, misleading, or deceptive advertising. The company, he claimed in a February 20 press release, sells chest binders “to Texas girls as young as nine-years-old to ‘transition’ them” without “informing them that they could be subjected to no less than twenty-eight different medical conditions.”
According to the World Professional Association for Transgender Health’s (WPATH) 2022 Standards of Care for the Health of Transgender and Gender Diverse People, trans masculine young people who bind their chests — described as a reversible, nonmedical practice that involves “compression of the breast tissue to create a flatter appearance” — report benefits including “increased comfort, improved safety, and lower rates of misgendering.” Risks such as back/chest pain, shortness of breath, and overheating are common. However, more serious risks, such as those Paxton cites in his lawsuit, like skin infections, respiratory infections, and rib fractures, are rare and more common among adults.
Paxton’s complaint includes multiple misrepresentations of medical research. Them notes it cites WPATH’s acknowledgement of certain risks associated with chest binding, but fails to note the infrequency of those risks among young people or the benefits when done properly.
The lawsuit also cites research published in the International Journal of Sexual Health last year, which found a “significant number of negative health implications” reported among trans and nonbinary people who bind. However, researchers also noted that “some studies also found positive effects on dysphoria, life satisfaction, and mental health,” and noted that several studies indicated a lack of knowledge about binding among healthcare providers. Researchers recommended further research “on long-term effects, safer methods, and promoting education” on chest binding.
The complaint also cites the U.S. Food and Drug Administration’s recent interpretation of chest binders as Class I medical devices under section 201(h) of the Federal Food, Drug, and Cosmetic Act because they are “intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, or to affect the structure or any function of the body.” Under this interpretation, Paxton alleges Lola Olivia is in violation of the Federal Food, Drug, and Cosmetic Act by not registering its products with the FDA. But the Dallas Voice notes that the FDA has said class 1 medical devices, which include items like manual stethoscopes and bedpans, “are generally exempt from premarket notification and approval.”
In his press release, Paxton falsely described “transitioning” minors as “child abuse” and accused Lola Olivia of making “a fortune by hurting kids.”
The lawsuit seeks a temporary restraining order, injunctive relief, and over $1,000,000 in monetary relief, including civil penalties.
Texas Attorney General Ken Paxton (R) has declared that it is illegal for mental health care providers licensed by the state to affirm trans youth and that doing so is child abuse.
The virulently anti-trans official issued the opinion on Monday to explain that the state’s gender-affirming care ban applies to mental health care as well. In a press release, Paxton’s office referred to the practice of affirming someone’s gender as “‘transitioning’ our kids.”
“Any radical facilitating the ‘transitioning’ of our kids is committing child abuse,” Paxton said in a statement. “The law is clear that these radical procedures are illegal and in no world should Texans’ tax dollars be used to permanently harm children. This opinion should send a clear warning there will be consequences for any medical professional, whether a doctor or a therapist, who is illegally ‘transitioning’ Texas kids.”
Trans news site Transitics said the opinion can be interpreted as essentially requiring mental health professionals to either refuse to see young trans patients or else engage in conversion therapy. The opinion states that therapists have an obligation to help children with “overcoming” an “underlying… condition,” which in this case is gender dysphoria.
“Even if they want to, they can no longer affirm a trans kid’s identity, offer alternatives in another state, or encourage parents to accept their kids for who they are,” Aleksandra Vaca at Transitics explained. “Under Paxton’s opinion, doing anything other than push a child to accept being their assigned sex at birth will result in providers losing their license and/or being imprisoned. This is conversion therapy, which is recognized by the United Nations as being tantamount to torture.”
Paxton has spent his tenure as attorney general terrorizing the trans community. In 2022, he issued a non-binding opinion calling gender-affirming health care a form of child abuse, which led Gov. Greg Abbott (R) to order the Texas Department of Family and Protective Services (DFPS) to investigate for child abuse any parents who allow their trans children to access gender-affirming medical care prescribed by their doctors.
Paxton was previously impeached by the Texas House in 2023 for 16 counts of bribery but was later acquitted by the Texas Senate. The FBI also investigated him for years for securities fraud, but the Department of Justice eventually dropped its investigation. He also settled a state securities fraud case against him, paying $300,000 and participating in community service to avoid legal charges.
In July, it came to light that his wife filed for divorce from him due to adultery.
Paxton told his staff about an extramarital affair in September 2018 while holding hands with his wife, The Texas Tribune reported. But while he recommitted to their marriage during that confession, he continued to cheat on her, the publication reported, even going through great lengths to hide affairs from her: using burner phones, secret email addresses, and secret rideshare accounts to meet with his mistress.
Attorney General Ken Paxton sued Children’s Health System of Texas and a Dallas doctor Wednesday for allegedly violating a Texas ban on gender-affirming care for minors.
The AG asked a Collin County judge for a temporary injunction to stop the two defendants from providing any gender-affirming care or filing any claims to Texas Medicaid for that care.
The suit alleges Jason Jarin, a pediatric and adolescent gynecologist at Children’s Health and associate professor at UT Southwestern Medical Center, violated the law with 19 patients. It alleges he violated a 2023 law that prevents health care providers from giving transgender youth puberty blockers, hormone replacement therapy or surgery for the purpose of transitioning — one of a number of Texas laws aimed at limiting the type of care transgender adults and children can receive.
Paxton also argues Jarin filed claims for these services with Texas Medicaid, which doesn’t cover any gender-affirming care.
“This criminal extremist not only permanently harmed children, but he also then defrauded Medicaid and stuck Texas taxpayers with the bill for this insanity,” Paxton wrote in a statement. “Experimental ‘transition’ procedures on minors are illegal, unethical, and will not be tolerated in Texas.”
Jarin told KERA News Wednesday morning he had just learned of the lawsuit, and declined to comment.
Children’s Health told KERA in a statement its “top priority is the health and well-being of the patients and families we serve.”
“We comply with all applicable local, state and federal health care laws. Due to ongoing legal proceedings, we are unable to comment further at this time,” the statement read.
Jarin became an assistant professor at UT Southwestern in 2016 and has published studies on transgender children, according to his faculty profile.
Many of the lawsuit allegations claim he intentionally prescribed extra hormones for transgender kids leading up to Sept. 1, 2023, when the law took effect, so that they could continue to get treatment.
The law, known as Senate Bill 14, did allow for prescriptions to continue for children who were “already subject to a continuing course of treatment that began prior to June 1, 2023,” and children who “attended at least 12 mental health counseling or psychotherapy sessions over a period of at least six months prior to starting treatment,” according to Paxton’s suit. But those prescriptions had to be for the purpose of weaning the patient off the drug.
Jarin is accused of violating SB 14 with 12 of the 19 patients. If found liable, he could lose his medical license — SB 14 requires the Texas Medical Board to revoke the license of any physician who provides gender-affirming care to a child.
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