Autistic Children Are Not Collateral Damage: How Many More In The Name Of Ideology?
Autism Organisation speaks out again in the Gender Debate
The Danish autism organisation Autisme-og Aspergerforeningen have released another huge piece speaking out with a wake-up call for autism advocacy and politicians to stop the state-sanctioned harm. I’ve reported on their advocacy before here, here and here. The evidence is in - will anyone listen?
Here is the English translation from their website:
Will a prime minister apologise for the chemical castration and sterilisation of autistic minors?
Disclaimer:
This article contains views and analysis that may be provocative or challenging to some readers. The purpose is not to offend, but to present a thorough and well-considered review of a topic that we believe is of great importance. We encourage you to read the entire article in its full context before drawing conclusions. Only in this way can the concerns and arguments presented be understood in their proper context.
November 12, 2019
It could be that in 30-40 years we will have a government that has to apologize to these children because they did something wrong
Danish People's Party's health spokesperson, Liselotte Blixt
Politicians confused about hormone therapy for children: 'A terrible dilemma' | Indland | DR
The enemy of your enemy is not necessarily your friend!
While parliamentary politicians from both the right and the left throw mud at each other and accuse the other party of transphobia, trans ideology or hatred, there is one thing they almost all ignore: the historical and current treatment of autistic people in Denmark.
For while some hold Trump responsible for a wave of transphobia, it is often forgotten that Trump himself – in collaboration with controversial figures such as Robert F. Kennedy Jr. – has helped perpetuate the idea that autism is a defect that should be corrected or medicated away. Ironically, this is precisely the kind of medical intervention that many of Trump’s opponents – including progressive advocates of early hormone therapy – increasingly want to offer autistic minors, simply under the pretext of gender incongruence.
This reveals a deeper ethical dilemma: When both the right and the left reduce autistic people to partisan political agendas, we risk repeating the mistakes of history – just in new and more “inclusive” guises.
Politicians who have been swept up in identity politics often refer to intersex people – people with variations in biological sex development, also known as DSD (Disorders/Differences of Sex Development). Examples of such variations include Klinefelter syndrome and Turner syndrome.
One can rightly ask the question: Have the politicians even asked those they are talking about?
According to VIVE's report "Intersex" , the people surveyed with DSD diagnoses express a clear reluctance to be placed under the LGBT+ umbrella and the designation "intersex".
Here one can rightly ask – Who has convinced politicians to use this particular target group as an argument in a gender identity debate?
"All interviewees identify themselves as either male or female, but the majority do not see themselves as intersex and do not identify as LGBTI. If one can speak of a relationship, it is more related to specific diagnoses such as Klinefelter syndrome and Turner syndrome."
(Appendix 1)
What is Intersex? (video)
Children are introduced to gender identity at an early age
Today, educators and school teachers are encouraged to have an increased focus on gender and gender identity – a focus that may be inappropriately extensive. This applies right down to kindergarten, where educators are guided to find literature on transgenderism that is considered to be age-appropriate, but which others question. The contrast seems glaringly large compared to the lack of upskilling after the inclusion reform. On Denmark's learning portal, there is a significantly large content of LGBT+ learning materials that primary schools are obliged to teach. There is not the same large amount of knowledge and learning material on the portal about neurodiversity and the disabilities that come with diagnoses such as ADHD and autism. Despite the fact that the inclusion of this group was enforced in 2012. This clearly shows the political and economic priorities in the primary school area. (Appendix 2) (Appendix 3)
It is well documented that people with autism generally show increased vulnerability to manipulation, grooming and sexual exploitation. Studies show that children aged 7–18 with developmental disorders have up to a 90% higher risk of being exposed to sexual abuse, which should constitute a central issue both politically and professionally. Violence and sexual abuse against children and young people with disabilities thus constitute a serious and under-exposed social problem. This calls for strengthened efforts based on evidence, interdisciplinary knowledge and ethical responsibility with a view to ensuring the target group protection, security and real rights in practice. (Appendix 4)
In this article you can read more about who Robert F. Kennedy Jr. is and why his appointment of David Geier is problematic for Denmark's health and disability policy - especially for autistic people.
In the following, you will also be presented with reasons why an increasing number of autistic people experience their existence being invalidated and that the functional impairments associated with autism are systematically overlooked or ignored.
This raises a number of important questions:
Where are the professionals who should be responsible for the protection of autistic children, young people and adults? What role have child psychologists played in this development? And when did it become pedagogically and psychologically sound to let children deal with their (gender) identity before this identity is fully developed? What role have child psychologists played in this development? – if any at all?
Financial incentives behind early hormone therapy?
At a time when the Danish welfare model is under financial pressure and savings are being implemented in this particular area, it is worth asking how ideologically extreme approaches are gaining ground. For although Denmark has a strong tradition of basing policy on evidence and human rights, we should not underestimate how susceptible our priorities are – and have already been – to international trends.
One possible thesis is that the lack of professional and political opposition to early hormone treatment of autistic youth may have an economic ulterior motive. By allowing these young autistic people to receive medical treatment at a time in their lives when the long-term consequences – such as reduced fertility and thus the loss of the ability to reproduce – are not yet clear, it is conceivable that the idea is to minimize future costs for social services, psychiatric help and long-term support. It is a cynical but logical conclusion in a system that already sees disability and autism as a burden.
When politicians consider proposals for medical treatments that require health professional explanations – preferably from multiple angles, so that a fully informed picture of the problem they want to change through legislative proposals is obtained – the party political preoccupation with electoral votes seems to outweigh the responsibility to care for vulnerable citizens in Denmark, especially minors.
By making the progressive and uncritical approach to gender the explanation for children's unhappiness, the costs are shifted from the special area towards the somatic area. In this way, the total costs in primary school and psychiatry can be kept down. At the same time, autistic children have increasingly become a vulnerable and overlooked group. The school reform disguised as inclusion in the Primary School Act has meant that many autistic children end up involuntarily absent from school because their classmates do not share their way of thinking and experiencing the world – and the teachers are usually not equipped to teach them with the right pedagogical tools.
When you don't learn from the dark chapters of history
Denmark's past also tells a dark story, where the state accepted the sterilization of people with disabilities - such as autism.
Carla was one of approximately 13,000 people, mostly women, who were sterilized in Denmark between 1929 and 1967. The background was the Act on Access to Sterilization, which came into force on 1 June 1929. This law allowed people with disabilities to be sterilized to prevent them from having children. The law was a central part of the Danish eugenic/racial hygiene policy of the interwar period. Eugenics and racial hygiene were not explicitly stated in the text of the law, but were evident in the political debate about the proposal. Denmark was thus the first country in Europe to implement such legislation, and during the 1930s the legislation was expanded and given clear racial hygiene purposes . (Appendix 5)
If you want to know more, watch this documentary:
The publication "Historical investigation concerning children, young people and adults placed in special care institutions 1933-1980", available via Folketinget.dk, sheds an important light on the often harsh and undignified conditions that many placed people experienced for almost five decades. The report documents a time marked by systemic failures, abuses and a lack of care on the part of the state towards some of society's most vulnerable groups.
The report is based on both archival material and testimonies from former detainees.
On 8 May 2023, Minister of Social Affairs and Housing Pernille Rosenkrantz-Theil issued an official apology on behalf of the government for the many abuses that people placed under the state's special care were subjected to. The assaults included violence, rape, use of force, forced sterilization and castration.
The apology marked a historic recognition of the failures and abuses these people were subjected to – and expressed the state's responsibility and willingness to learn from the mistakes of the past.
International influence on Danish disability policy
The mixing of ideology, medicine and political strategy is nothing new – not even in Denmark. For decades, Danish disability policy has been influenced by international trends, especially from the United States, where the view of autism and disability has often been characterized by notions of control, normalization and economic efficiency. What we are now seeing, however, is a new wave, where these ideas are linked to identity political agendas and medical practices that in practice risk reinforcing the marginalization of autistic people.
As actors like Donald Trump, Robert F. Kennedy Jr., and David Geier gain a new foothold in the global debate, it is no longer a question of whether their ideas will influence us – but rather how they are already entangled in our own health and disability priorities. And that is true regardless of which political wing one belongs to.
RFK Jr. appointed Secretary of Health – a controversial decision
In February 2025, Robert F. Kennedy Jr. was confirmed as the United States Secretary of Health and Human Services after a close vote in the Senate. Kennedy, known for his controversial views on vaccines and public health, was nominated by President Donald Trump as part of a broader strategy to reform the American health care system. His appointment has raised concerns among health experts and politicians, particularly given his past criticism of vaccine programs and public health initiatives. (Exhibit 6)
Kennedy's policies create unrest in the healthcare sector
As Secretary of Health and Human Services, Kennedy has implemented a number of initiatives, including cuts to public health programs and changes to vaccine recommendations, which have led to debate about the public health implications. His approach has also resulted in resignations among scientific staff and drawn widespread criticism from the medical community. (Appendix 7)
Kennedy's appointment and subsequent appointments of individuals to lead various initiatives have created unrest, concern, and anxiety in the United States, especially for autistic people and their families.
“Autism epidemic” – a vaccine skeptic’s fight against science
Robert F. Kennedy Jr. (RFK Jr.) has been a prominent skeptic of the conventional understanding of autism and the possible causes of autism. In particular, RFK Jr. has been an advocate of conspiracy theories about the MMR vaccine and its “connection” with autism. He has argued that there is an “autism epidemic” and, as Secretary of Health and Human Services, has expressed a desire to investigate what may be behind this increase in autism diagnoses. (Appendix 8)
“Robert F Kennedy Jr adresses autism rise and causes in latest CDC report” YouTube video.
Vaccines and autism – a myth revived
Kennedy has for years put forward theories about a possible link between vaccines and autism, in particular he has focused on the MMR vaccine which, among other things, protects against measles. There is currently an outbreak of measles in the USA and in February an unvaccinated child died of the disease. Several deaths have been reported to the American authorities where the cause has been measles. (Appendix 9)
The claim that the MMR vaccine is linked to autism has been rejected by a large majority of scientists and health authorities worldwide. JFK Jr. has particularly criticized the use of the mercury compound thimerosal in certain vaccines, which he claims may be a contributing factor to the rise in autism – despite the fact that numerous studies have found no such link.
"It should also be said that if you take a can of mackerel in tomato sauce, you actually get more mercury than from a shot of vaccine," says professor of infectious immunology at the University of Copenhagen, Jan Pravsgaard Christensen.
The MMR vaccine: The 6 biggest myths debunked by science
RFK Jr. has appointed David Geier to lead a study on the connection between vaccines and autism, which has already been refuted by several international studies, including a large Danish study . Several have speculated that with RFK Jr.'s attitudes towards science and with his appointment of David Geier, one can therefore with good reason fear that the upcoming study will be set up in such a way that it will inevitably "prove" such a connection. The consequences of such a conclusion can be imagined, with their attitudes and backgrounds, especially David Geier's, to be far-reaching, cruel and inhuman. (Appendix 10) (Appendix 11)
David Geier- convicted as a quack
It is deeply concerning that RFK has appointed a quack to lead a study on vaccines and autism. Several health professionals and senators have expressed great concern about Geier's appointment. (Appendix 12) This is based on David Geier's family relationships, especially with regard to his own father Mark Geier (Doctor of medicine, MD). David Geier, in collusion with his now deceased father, Mark Geier, conducted experimental medical trials on autistic minors. The goal of the medical trials was to normalize and cure people of their autism. They themselves called their treatment method a miracle cure for autism and the treatment was named "the Lupron protocol". (Appendix 13)
Among the many organizations, health professionals and political figures, ASAN – Autistic Self Advocacy Network, has expressed strong condemnation of the appointment of David Geier. They express, among other things, the following:
“Anyone who would fleece families with fake cures should not be trusted to interpret a scientific study , let alone conduct one .” ( Appendix 14)
“Anyone who wants to rip off families with fake cures should not be trusted to interpret a scientific study, let alone conduct one .”
Senator Margaret Wood Hassan, an American politician and lawyer, has expressed her concern in an appeal to Health Secretary Robert F. Kennedy Jr., writing, among other things:
"The Geiers administered a potent medication called Lupron, a testosterone-suppressant approved for prostate cancer and ovarian fibroids, to children with autism, despite these children having no diagnosed conditions that would necessitate this treatment " (Appendix 15)
“The Geiers administered a potent medication called Lupron, a testosterone inhibitor approved for prostate cancer and uterine fibroids, to children with autism, despite the fact that these children had no diagnosed conditions that would necessitate this treatment.”
Chemical castration of autistic minors
But the reality was that the Geier duo's "miracle cure" was actually a chemical castration of autistic minors (Appendix 16) and they received criticism from many professionals at the time for their experimental medical experiments using Lupron on minors. Among others, Simon Baron-Cohen, professor at the University of Cambridge, stated:
"The evidence to support the hype is lacking. University of Cambridge Professor Simon Baron-Cohen blasted the approach, telling the Trib, "The idea of using it with vulnerable children with autism, who do not have a life-threatening disease and pose no danger to anyone, without a careful trial to determine the unwanted side effects or indeed any benefits, fills me with horror" (Appendix 17)
“The thought of using it on vulnerable children with autism, who do not suffer from a life-threatening illness and pose no danger to others, without a careful study of any unwanted side effects or any benefits at all, fills me with horror. ”
Mark Geier, lost his license to practice in 9 states and David Geier was prosecuted and convicted for performing treatments on a child without professional qualifications. (Exhibit 18)
Today, their experimental attempts on autistic minors are looked back on as abuse, but this has not had major consequences for anyone other than the vulnerable people who have been exposed to the quackery of the father-son duo. (Appendix 19)
“Dangerous or Deadly Cures for Autism and Other Developmental Disabilities” YouTube video.
The adolescent brain – in general
A pubertal brain is characterized by a number of cognitive and emotional changes that affect the adolescent's behavior and decision-making. One of the most prominent features is increased risk-taking, especially around the age of 18. This is because the reward system in the brain, which is responsible for regulating pleasure and reward, develops faster than the areas that govern impulse control and consequential thinking. This can lead teenagers to engage in risky behaviors such as reckless driving, experimenting with drugs or alcohol, and other impulsive actions.
Black-and-white thinking, also known as dichotomous thinking, is another characteristic of the adolescent brain. Teenagers tend to see the world in extreme terms, where things are either good or bad, right or wrong, without acknowledging the nuances in between. This can make it difficult for them to see middle ground or compromises and can lead to conflicts with parents, teachers, and peers.
A lack of foresight is also prominent during this period. Because the areas of the brain responsible for planning and assessing long-term consequences are not yet fully developed, teenagers may have difficulty anticipating the consequences of their actions. This can result in impulsive decisions that they later regret.
These cognitive changes are a natural part of brain development and help shape young people's identity and autonomy. Understanding these processes is important to better support teenagers through this challenging period.
“Why the teenage brain has an evolutionary advantage” YouTube video
Delayed maturity in autistic youth
In Denmark, young people from the age of 15 can make decisions about gender reassignment treatment without parental consent. For autistic young people, whose maturity is often 30% lower than their peers, this is particularly problematic.
When dealing with autistic young people, it is crucial to take into account that their maturity is often delayed compared to their peers. Research shows that when diagnosing autism, up to 30 percent should be deducted from the maturity level compared to young people without autism. This means that a 15-year-old with autism may have a maturity level corresponding to a significantly younger age group. This reduced maturity reinforces the importance of ensuring a thorough assessment and support from parents before irreversible decisions about gender reassignment treatment are made. This is supported by the Parental Responsibility Act §5: “In all matters concerning the child, the child’s own views must be taken into account according to age and maturity ”.
Autistic girls enter puberty on average 9.5 months earlier than their same-sex peers, which can make the onset of puberty even more challenging and often traumatic. (Appendix 20)
In the Autism and Asperger Association, we experience time and again that professionals express to us that they do not dare to question the conviction of young autistic people to have a different gender than the one they were born with. Questions about gender identity are surrounded by a fear of committing a faux pas, which can lead to consequences in the form of shaming on social media, firing or fear of this, due to accusations of discrimination, etc.
What happens to brain development during puberty?
During puberty, the brain undergoes significant development, both structurally and functionally. Here are the most important changes that occur:
1. Pruning (pruning synapses)
The brain “prunes” redundant synapses (connections between brain cells), especially in the frontal lobe.
This is a kind of “cleanup” where the connections that are used frequently are strengthened and the others disappear.
It improves brain efficiency, but also makes young people more susceptible to the environment and experiences.
2. Myelination
Myelin, a fatty layer around nerve cells, increases, making signal transmission faster and more efficient.
This occurs especially in connections between different parts of the brain and supports better planning, control and decision-making.
3. Development of the frontal lobe
The frontal lobe (especially the prefrontal cortex) is responsible for planning, impulse control, risk assessment, and empathy.
It is not fully developed until the mid to late 20s.
Therefore, teenagers often have more impulsive behavior and poorer risk assessment.
4. Increased activity in the limbic system
The limbic system, which controls emotions and the reward system, matures earlier than the frontal lobe.
This means that emotions, rewards and social influences play a large role in adolescence.
5. Hormone influence
Hormones such as testosterone and estrogen affect the structure and function of the brain.
It can contribute to changes in mood, sleep patterns, and social behavior.
Overall, these changes mean that adolescents during puberty are often more emotionally impressionable, seek excitement and social recognition, but do not yet have fully developed abilities for self-control and long-term planning.
Reference list – Brain development during puberty
Blakemore, S.-J. (2012).
Imaging brain development: The adolescent brain.
NeuroImage, 61(2), 397–406.
https://doi.org/10.1016/j.neuroimage.2011.11.080Giedd, J. N. (2004).
Structural magnetic resonance imaging of the adolescent brain.
Annals of the New York Academy of Sciences, 1021(1), 77–85.
https://doi.org/10.1196/annals.1308.009Casey, B. J., Jones, R. M., & Hare, T. A. (2008).
The adolescent brain.
Annals of the New York Academy of Sciences, 1124, 111–126.
https://doi.org/10.1196/annals.1440.010Steinberg, L. (2008).
A social neuroscience perspective on adolescent risk-taking.
Developmental Review, 28(1), 78–106.
https://doi.org/10.1016/j.dr.2007.08.002Luna, B., Padmanabhan, A., & O'Hearn, K. (2010).
What has fMRI told us about the development of cognitive control through adolescence?
Brain and Cognition, 72(1), 101–113.
https://doi.org/10.1016/j.bandc.2009.08.005Dahl, R. E. (2004).
Adolescent brain development: A period of vulnerabilities and opportunities.
Annals of the New York Academy of Sciences, 1021(1), 1–22.
https://doi.org/10.1196/annals.1308.001
The role of social media and misinterpretations of gender identity
Over the past 10-15 years, social media such as TikTok and YouTube have taken on a significant and sometimes worrying role in the lives of minors and young people. Historically, there are several cases where social contagion has caused episodes of mass hysteria or mass psychosis. A more recent example of this is the period when videos on social media showed creepy people dressed as clowns. These videos quickly went viral and created insecurity among many minors. Parents reported how their children became very absorbed in the videos, which affected them in their daily lives – both emotionally and behaviorally. (Appendix 21)
Minors get their information via social media, be it from what is happening with their favorite influencers, news, but also puberty-related topics. This also means that social media can quickly become an oracle that can “help” minors interpret their puberty-related discomfort and challenges. A worrying trend is that some young people – especially minors – may misinterpret these bodily sensations and feelings as gender dysphoria and see hormone treatments as a universal solution to all their challenges. For example, feeling different, sensory discomfort and not having the same interests as peers of the same sex. It is society’s duty to protect these vulnerable minors from hasty medical decisions. The lack of long-term studies makes it impossible to assess the full risks of giving minors hormone preparations or puberty blockers.
This obligation is even greater when there are signs that autistic traits or other psychiatric challenges are being confused with gender identity problems. But there is also an unpleasant possibility that should be considered. (Appendix 22)
Lupron is Lupron, just like penicillin is penicillin.
Penicillin is prescribed by doctors to treat many different illnesses, but the side effect profile remains the same. We all react differently to medical treatments, but most people know that penicillin can cause nausea and diarrhea.
Lupron (Leuprorelin) which Mark Geier and David Geier used as a “miracle cure” to cure minors of their autism is still used today. Even so, it is still used for unapproved purposes, on minors. Leuprorelin is better known as Stop hormones and the only approved treatment where this product is approved is for children who go through premature puberty.
What is precocious puberty (pubertas praecox)?
Precocious puberty in girls is: the beginning of breast development or pubic hair before the age of 8 or the first menstruation before the age of 10.
Precocious puberty in boys is : the beginning of testicular growth or pubic hair before the age of 9"
In the above examples, there may be an indication for a specialist in pediatrics or endocrinology to prescribe leuprorelin. The children who are offered treatment for precocious puberty will be closely followed by specialists, both in relation to the treatment itself and in relation to their physical and mental development. After completing medical treatment, the children will be closely followed until their natural puberty occurs. (Appendix 24)
Gender dysphoria does not have a specific diagnostic code, as is often required for other diseases/disorders where treatment with particularly potent medications is given. Therefore, gender dysphoria is treated based on criteria and screening tools (Tanner stage) that are based on the treatment offered to children who have gone through puberty prematurely.
Tanner stages, girls – Patient handbook on sundhed.dk
Tanner stages, boys – Patient handbook on sundhed
Today, Leuprorelin (aka Stop-hormone/Lupron/Prostap, etc.) is one of the primary hormone preparations in the treatment of minors who state that they are transgender. Here, a doctor can prescribe various types of leuprorelin-containing medications to minors who have expressed a desire to change gender, and for this type of treatment, the medication is prescribed as off-label prescriptions.
Off-label
The use of prescription medication must, as a general rule, be within the approved therapeutic indication of the drug. However, it is possible for the individual physician to use a drug off-label independently and at his own risk based on a specific assessment of the treatment needs of the individual patient.
In the case of off-label prescribing, as with all other medicines, the treating physician has professional responsibility for prescribing the medicine and must familiarize himself with dosage, side effects, contraindications, special warnings and precautions.
Medication management | Danish Patient Safety Agency
This means that this type of medicine is prescribed for a therapeutic purpose for which the medicine is not approved. For the treatment of gender incongruence in minors (11 years+), they are often already well into their natural puberty. For this type of treatment, the evidence for a positive result is lacking, especially when compared to the already well-known side effects.
Because with the knowledge we have about the side effect profile of Leuprorelin, the medicine should not be prescribed to minors at all, especially when the medicine is not approved for such a therapeutic purpose. There is much evidence that young people who have undergone long-term treatment with Leuprorelin-containing medicine experience side effects such as osteoporosis, fertility problems and mental development that has stalled. (Appendix 25)
The otherwise close healthcare follow-up offered to children who have gone through puberty prematurely is unfortunately absent from the group of minors who, from the age of 11, can receive treatment with stop hormones for gender incongruence. (Capital Region of Denmark, VIP, Hormone treatment of transgender young people under the age of 18)
We ask: Is there any medical rationale that justifies the presence of follow-ups for minors who have gone through puberty too early, but at the same time is absent for minors when it comes to gender incongruence, despite the fact that these are the same medications that are used to treat minors?
Lupron's effects on the brain
Leuprorelin acetate (also called leuprorelin or under trade names such as Lupron) is a gonadotropin-releasing hormone (GnRH) agonist that temporarily inhibits the body's production of sex hormones (estrogen and testosterone). It is used to treat, among other things, premature puberty (puberty precocious) , gender-conserving treatment in transgender youth , and certain types of cancer.
When given during adolescence, it can affect brain development – both directly and indirectly – through the following mechanisms:
1. Hormonal influence on the brain
Sex hormones (especially estrogen and testosterone) play an important role in brain maturation, especially during puberty.
Leuprorelin acetate suppresses these hormones, which can delay the development of structures such as the frontal lobe and limbic system .
This can affect the development of social, emotional, and cognitive functions , as hormones are involved in synaptic reorganization and neuroplasticity.
2. Mental and emotional effects
Changes in mood, depression, fatigue, and emotional flatness have been reported in some young people in treatment.
This may be due to both the direct effect of hormone reduction and secondary psychosocial factors (e.g. identity, the importance of treatment, etc.).
3. Impact on brain structure (potentially)
Research suggests that prolonged suppression of puberty hormones may delay certain parts of the brain's structural development , but the evidence is still limited and evolving.
A 2020 study (Frigerio et al.) found that transgender youth who received GnRH agonists had less white matter development over time compared to control groups – but the consequences of this are not fully known .
4. Memory and cognition
Some studies point to possible mild impairments in working memory and verbal function , but the findings are not clear and require more research.
It is not known whether these changes are temporary or permanent.
References
Reference list
Chen, D. et al. (2020).
Psychosocial outcomes in transgender youth undergoing GnRH agonist treatment. Pediatrics , 146(4), e20194046.
Need for debate on medical and political ethics
In light of the above, it must be considered crucial to raise a debate about the responsibility of politicians when prioritizing funds in the health sector. For years, autism advocates have been calling for more resources for psychoeducation about autism – for both children, young people and adults. Yet, offers of psychoeducation after assessment and diagnosis of autism have largely disappeared. On the other hand, the coffers seem almost bottomless when it comes to initiatives related to gender identity.
It is striking that society is willing to invest enormous resources in children with gender dysphoria, while children with disabilities, such as autism, continue to be left behind. Autistic children struggle daily with inadequate schooling, minimal specialized help and a pervasive neglect of their needs. But it does not seem to arouse the same political or economic interest as gender dysphoria. Regardless of which gender the child chooses to identify with, their autistic challenges will always be there.
Consultation response to 'Guidance on health professional help for gender incongruence' and 'Framework for health professional help for gender incongruence' – The Autism and Asperger Association
Who actually bears the political responsibility for ensuring that Denmark adheres to strict ethical standards in medical treatment – especially when it comes to impressionable and vulnerable minors? And how can we be sure that the dark chapters of history – forced sterilizations, inhumane experiments and systematic abuse – are not repeated in a modern guise, where “progress” or “self-determination” are used as an excuse to legitimize castration?
There are currently practices in the Danish healthcare system that directly or indirectly lead to the sterilization or castration of young autistic people. Has an ideological narrative been allowed to manipulate our society into believing that experimental treatment is the right and responsible healthcare path to take? These are not just theoretical concerns – these are issues with concrete consequences for people whose lives and bodily integrity are at stake.
Lack of patient safety – Gender affirming affirmation seems like the exception to everything.
Gender-modifying treatment can now be given to young people as young as 15 without parental consent – and as young as 11 if the parents give consent.
"Young people between the ages of 8-15 (girls) and 9-16 years (boys) may need early assessment of growth and puberty when signs of puberty are found at the initial interviews or there is doubt about puberty development." (Appendix 26)
But is consent even valid when the evidence for the treatment is so weak? Can one give truly informed consent when even the treating doctors cannot provide the necessary information – because it does not exist?
As Katharina Maria Main from the Clinic for Growth and Reproduction at Rigshospitalet is quoted on November 12, 2019:
"There is a lot of knowledge we lack. What happens to a body that has the Y chromosome in all cells when I give estrogen for 70 years and vice versa?"
Politicians confused about hormone therapy for children: 'A terrible dilemma' | India | DR
Based on a political decision, the Danish Health Authority removed transgenderism from the list of mental disorders on January 1, 2017. This can create challenges for patient safety, especially when treatment is offered to minor autistic people who are already vulnerable and have special challenges that should be taken into account.
In a letter of concern from February 2025, the Center for Gender Identity (CKI) - Odense and Copenhagen, acknowledged that they do not have the necessary expertise or competencies in the departments to be able to assess and treat autistic minors. (Appendix 26)
We therefore find it worrying, from a patient safety perspective, that in connection with gender modification treatment, the same care is not taken when it comes to the sterilization that occurs during the medical treatment of gender dysphoria. According to the Health Act, women over 18 years of age, or those whom the law designates as 'persons with a uterus ', must have a 6-month reflection period from the time they have contacted the health authorities with a desire to be sterilized. (Appendix 27)
The Chairman of The Scottish Council on Human Bioethics, Dr. Antony Latham, General Practitioner, has, in an article for The new Bioethics, described the ethical problem of minors being asked to consent to treatments that have far-reaching effects on the child’s life. The article “Puberty Blockers for Children: Can They Consent?” states, among other things:
"Almost 100% of those who started on stop hormones continued to take cross-hormones; in 98 % of cases, according to GIDS (Gender Identity Development Service – Tavistock Centre) (Carmichael et al. 2021) and many of these will also have surgical procedures such as mastectomies and genital surgery. Gender reassignment surgery is on the rise.
Infertility is very likely when stopping hormone intake is followed by cross-hormones. Cretella (2016, p. 53) writes:
Since GnRH agonists (stop hormone) prevent the maturation of gonadal tissue and gametes in both sexes, adolescents who go from puberty suppression at Tanner Stage 2 to cross-sex hormones will become infertile without any possibility of having genetic offspring in the future because they will lack gonadal tissue and gametes for cryo-preservation. The same result will happen if prepubertal children are placed directly on cross-sex hormones.
Embarking on stop hormones, therefore, means that the individual is likely to become infertile. The question is whether a child who is counseled about stop hormones can really understand the consequences of being infertile and give informed consent. "The treatment of childhood gender dysphoria with hormones effectively constitutes a mass experiment on and sterilization of adolescents who are cognitively incapable of giving informed consent" (Cretella 2016, p. 53).
The irreversibility of cross-hormones causes the voice to deepen and male hair growth, and the long-term effects of surgery are obvious. Blockage of puberty in boys causes underdevelopment of the genitals. This, in turn, makes subsequent vaginoplasty (the surgical formation of an artificial vagina) more complicated (Bizic et al. 2018). In light of these facts, the statement that stop hormones are "reversible" sounds at least misleading. The child taking stop hormones will almost certainly have life-altering and irreversible physical side effects, which may be greatly regretted in the future."
Read the full research article here
The Scottish Council on Human Bioethics is an independent charity made up of professionals from various disciplines involved in medical ethics. Their purpose is to engage with current ethical issues in biomedicine, particularly those of particular concern in Scotland, and to provide a Scottish voice on the international stage. (Appendix 28)
In a recently published study, “Fertility preservation: is there a model for gender-dysphoric youth?”, concerns are expressed about the lack of fertility preservation options for minors who are medically treated with stop and cross hormones. They describe, among other things, that
Fertility preservation in the pediatric population increasingly includes transgender adolescents receiving gender-affirming treatment, in addition to patients with childhood cancer. Despite a significant risk of permanent sterility – up to 95% – fewer than 5% of these young people attempt to maintain fertility. An Australian study showed a marked difference between the birth-confirmed sexes of men (boys) and women (girls). Namely, that 62% of the men born chose fertility-preserving treatment, while none of the women born did. This may be because procedures such as egg retrieval or ovarian tissue collection in women (girls) are more invasive and complex than sperm collection in men (boys). Many transgender adults express regret that they cannot have biological children. At the same time, fertility-preserving counselling for treatment with puberty blockers and sex hormones is not standardised, and the proportion of young people receiving or using fertility-preserving treatment varies significantly – from 13.5% to 100% for counselling and 0 to 62% for actual use. (Appendix 30)
Political blinders
On 14 November 2024, the first reading of resolution proposal no. B 12 was considered in the Folketing. The proposal – submitted by Dina Raabjerg (KF) and others – aims to ensure that young people between the ages of 15 and 17 cannot initiate gender reassignment treatment without parental consent.
During the debate, several politicians expressed remarkable confidence in the judgment of young people and in healthcare professionals without autism expertise.
Christoffer Aagaard Melson stated:
“We have such confidence in young people in Denmark that we basically believe they can help make decisions about their own health.”
Kirsten Normann Andersen added:
“[We have] trust in the healthcare professionals who bear a huge responsibility for our health – even in some really difficult situations in our lives – but also trust that people know best what is good for them. This also applies to young people between the ages of 15 and 18, who of course should have influence over their own bodies and health.”
Peder Hvelplund :
"I actually believe that people should have the opportunity to make their own choices, and that is precisely what we ensure through informed consent in the healthcare system. Therefore, I have full confidence that the people best able to make that decision are the mature young people themselves."
Dina Raabjerg (KF):
“… Astrid Højgaard is the chief physician at a sexology clinic in Aalborg, and she is a member of the World Association for Trans Health, whose methods are under massive criticism. She has a young man who has been diagnosed with autism, in treatment, and his mother is deeply unhappy about this. She does not see an 18-year-old transgender man, but a young man who is autistic and for that reason has difficulty reflecting himself in other young men. The mother wrote the following to Astrid, which I have been allowed to read out to you:
I am deeply shocked that you are giving hormones to a young vulnerable person with autism, where it is stated loudly and loudly in his papers that he is not age-appropriate, that he has difficulty taking care of his own health and safety and difficulty taking appropriate responsibility, and who scores very low on self-care, has a low BMI, scoliosis and non-compliance in relation to regular medicine. I certainly hope that you will take responsibility when he regrets when his frontal lobes are fully developed and he has learned to understand his autism. Add, I must simply say. You are destroying entire families when you sit and play Lord over other people's children and young people. It is I who is faced with extra problems and help now, both in relation to compliance, finances for hormones, changing the name, etc., since he is not able to do it himself, as well as a broken sibling relationship. It affects everything around him.
Astrid refuses to discuss the matter with the young man's mother, because he has turned 18 .
In our opinion, it is deeply irresponsible and can be described as state neglect to leave such life-changing decisions to 15-year-olds, whose brains are not yet fully developed. A pervasive and serious problem in the issue of trans identity is that scientific and biological facts – which otherwise form the basis of our society and political decisions – are increasingly being disregarded, as if they no longer have any validity.
How can one trust healthcare professionals who can initiate treatment for a young autistic man who is not of the appropriate age, assessed by doctors with psychiatric expertise, and thus incapable of making such a life-changing decision, simply because he is 18 years old?
Suicide or attempted suicide
The argument about suicidal thoughts, attempts and suicide is often used in discussions about access to gender reassignment treatment. This is despite the fact that regardless of the gender of an autistic person, the suicide rate and risk of committing suicide is extremely high among autistic people. Again, this fact does not seem to arouse as many feelings of recognition and call to action among politicians.
Among people with psychiatric diagnoses, the risk of suicide is up to 10 times greater than among the population group without a psychiatric diagnosis. (Appendix 30)
People with autism have a more than threefold increased risk of committing suicide compared to the general population.
And it is particularly serious for women, where the risk is 4.4 times higher than for men, while women's risk of suicide attempts is as high as 8.5 times the risk among men. (Appendix 32)
According to the study, psychiatric comorbidity is the greatest risk factor for suicide among people with autism, with more than 90 percent of those who attempted or died from suicide also having another mental disorder. (Appendix 31) (Appendix 32)
Autistic children and young people deserve better protection – not an ideological gender journey without the possibility of a return ticket
The world can be overwhelming and confusing for autistic children and young people. Their need for structure and clarity is great, and when they encounter a societal development that encourages them to choose a gender identity from countless options, it can create more chaos than clarity. In the Autism and Asperger Association, we view with deep concern how an ideologically driven gender policy risks placing an additional burden on an already vulnerable group - and we appeal to professionals and politicians to put the real needs of autistic children first.
Based on the previously mentioned letter of concern from two out of the 3 centers for gender identity, we have contacted the Danish National Board of Health and are still awaiting a response.
Psychoeducation is not “conversion therapy” – it is responsible care
In the current debate, those who advocate the importance of thorough psychoeducation and talk therapy before any irreversible treatments are often met with accusations of engaging in “conversion therapy.” This comparison is not just wrong—it is harmful.
In our view, equating psychoeducation with conversion therapy is a concrete example of hate speech. When you portray a cautious, therapeutic approach – which is precisely intended to protect vulnerable young people from hasty decisions – as reprehensible, you undermine professional integrity and place ideology above the best interests of the child.
Worse still, non-pharmacological approaches that encourage self-reflection and acceptance are accused of being a form of “hate crime” against autistic people. The real harm lies in pushing young people towards quick fixes when what they often need most is long-term support and understanding. We consider the castration and sterilization of underage autistic people to be a hate crime.
From identity formation to “take-your-own-table” of gender
Puberty has always been a challenging phase of life, where young people seek to understand themselves and their place in the world. In the past, identity formation was about exploring who one is in relation to the outside world – now it is increasingly about choosing a gender identity from an endless menu of options.
Instead of expanding gender roles so that children and young people don’t feel locked into stereotypes, we have created a system where they have to navigate a maze of gender identities, each with its own social codes and expectations. This is an impossible task for many – not least autistic young people, who need clarity and not more choices that make the world more confusing.
Why are autistic young people particularly vulnerable?
Autistic people often have a strong need for stability and clear categories. When they encounter a narrative that gender identity is something you can and should choose, and that transitioning is the path to happiness, they may cling to this solution as a way to create order out of chaos. The problem is that many autistic young people do not receive the necessary holistic assessment that could reveal whether their gender confusion is due to other factors – such as anxiety, social difficulties, traumatic experiences or sensory overload.
Even more alarming is that once an autistic young person has embarked on a gender journey, there is often no going back. Regret or re-evaluating one’s identity is seen in many circles as a form of betrayal, which creates social pressure that can lock young people into an identity that may not suit them. We are experiencing a growing trend towards detransphobia – where young people who regret their gender identity journey are met with ostracism. This creates a sense of wrongness, rather than working with the whole person from the start.
We are experiencing a worrying trend towards detransphobia – where young people who regret their gender identity journey are not only met with ostracism, but are actively stigmatized and marginalized. They are subjected to a double punishment: first a sense of failure, and then social ostracism, which increases their isolation and risk of suicide.
This tragic development could be avoided if we worked more health-professionally and evidence-based with people who experience challenges in relation to their (gender) identity. by working with the whole person from the start. By carrying out the basic psychosocial work that takes into account all aspects of the young person's life and development. When we carefully examine the underlying causes, we can give young people the care and professionalism they deserve.
Grooming and normalization of fetish
At the Autism and Asperger Association, we observe with great concern how certain sexualized discourses have gradually penetrated youth culture under the umbrella of identity politics. This development poses particular challenges for autistic youth, who may already have difficulty navigating social norms and boundaries.
A particularly worrying trend in the current gender policy debate is the gradual normalization of adult sexual fetishes in youth culture – and how this can exploit the vulnerability of autistic youth. We are seriously seeing how certain ideological circles actively promote concepts such as “kinkshaming” as a form of oppression, which in practice can function as grooming by breaking down young people’s natural boundaries.
For autistic youth, who often have challenges with social interaction and boundary setting, this development is extra dangerous. When fetish culture is presented as a legitimate part of identity politics – for example, through concepts like “queer kink” or “trans-age” – an environment is created where young people can be exposed to adult sexual practices under the guise of “self-expression”. This is not liberation, but a breach of the ethical framework that is supposed to protect children and young people
How They’ve Turned a Generation Into Medical Conformists - Frank Furedi (#12) YouTube video.
Professionals should be extra aware of how autistic youth can become targets for:
Ideological grooming : When adult activists promote extreme gender or sexuality theories as the only truth
Sexualization of identity : When bodily changes or fetishes are presented as a natural part of gender expression
Peer pressure : When young people feel they must accept all forms of sexualized acts in order to be “inclusive.”
On major media platforms such as DR and TV2, children and young people are purposefully exposed to sexuality-related content, including kinks and fetishes, as if it were the most natural and normal thing in the world. An exposure that, consciously or unconsciously, gradually pushes the children's limits in a way that resembles grooming mechanisms. Complex concepts are packaged in an abbreviated, entertaining form – from reels that present fetishes as harmless "everyday things", to programs that reduce identity discussions to superficial categories. The result is an identity experiment in which children and young people are guinea pigs.
Appeal to professionals: Stop, think and assess the whole
At the Autism and Asperger Association, we believe that it is an adult's responsibility to make the world less confusing for children – not more complicated. Autistic young people have the right to be seen as whole people, not reduced to a single aspect of their identity.
Hold on to your professional expertise, both pedagogical, psychological and sociological.
Ensure a better and more nuanced assessment of autistic young people before irreversible treatments are initiated.
Focus more on underlying causes of gender confusion, such as anxiety, social difficulties, or other psychological challenges.
Provide support to those who regret so that they are not left in an identity that no longer fits them.
Autistic people should not be forced into a world of different gender identities to be part of the community. Just as we cannot change our height, our sensory sensitivity, or our neurology, we cannot always change the conditions we are born into. Sometimes it is not about “making the right choice” – but about learning to live with ourselves as we are.
We owe autistic children and young people a more nuanced and cautious approach – before it is too late.
The government of Canada is considering legalizing MAID for autism. Medical Assistance In Dying…
This is amazing insight and I’m glad I came across this. Thank you for sharing this!