Beth Ann Rosica: The tide is turning on transgender ideology

The gender ideology movement affecting countless children and adolescents across the country shows clear signs of fracture.

“Gender affirming care” — the practice of supporting and affirming an individual’s perceived gender identity when it conflicts with their sex — is now under a microscope, thanks to a landmark court case and two national medical associations.

Just last month, a West Chester County, New York jury awarded $2 million in damages to a young woman who, at age 16 transitioned from a girl to a boy and underwent a double mastectomy. Three years later, she regretted the decision, began the process to detransition, and filed a medical malpractice case against both her long-time psychologist and the surgeon who performed the mastectomy.

This is the first medical malpractice case against mental and physical health care providers related to sex change procedures for minors. Other cases are currently pending, and this award will likely spur more legal actions.

The $2 million award may be the beginning of the end of surgeries and prescriptions, such as hormones and puberty blockers, for children and adolescents. If future cases follow this same pattern, insurance companies may stop insuring doctors and practitioners who engage in these interventions.

While the financial aspect may be the impetus for the end of gender affirming care, professional ethics considerations may ultimately guide decision-making. 

Until recently, every major medical association in the United States not only supported, but strongly recommended, both medical and mental health interventions for minors aligned with gender affirming care — despite two comprehensive reports to the contrary. The Cass Review, published in 2024 by the National Health Services in England, and the Gender Dysphoria Report published in 2025 by the U.S. Department of Health and Human Services (HHS), reached the same conclusion that there was not enough evidence to support gender affirming care interventions with children and adolescents.

However, just this month, the American Society of Plastic Surgeons (ASPS) released an unequivocal statement, reversing course from previous positions, and in line with the Cass Review and HHS report.

“ASPS recommends that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.”

Following ASPS, the American Medical Association gave a similar, albeit less forceful statement to National Review.

“The evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement . . . the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”

However, the organization also said it supports “evidence-based treatment, including other types of gender affirming care for minors.”

Nationally, 27 states have enacted laws or policies blocking gender affirming care; however, Pennsylvania not only continues to support it, but mandated it as a requirement for mental and physical health providers.

In 2024, the Commonwealth banned the use of “conversion therapy” and allows for disciplinary action to be taken against any provider who engages in such treatment.

Prior to the onslaught of gender ideology aimed at children and adolescents around 2020, conversion therapy was considered an “attempt to change an individual’s sexual orientation from homosexual to heterosexual.” Previously, there was never any mention of gender identity related to conversion therapy.

Yet, under the Shapiro administration, the state attempts to conflate conversion therapy, an outdated concept traditionally geared towards eliminating homosexuality, with telling a child that they cannot change their sex.

Pennsylvania law states, “conversion therapy does not include a practice that does not seek to change sexual orientation or gender identity.” [emphasis added]

It further says, “the [licensing] Board may find the use of conversion therapy on an individual under 18 years of age to be unethical, immoral or unprofessional conduct. A Board-regulated practitioner who uses conversion therapy on an individual under 18 years of age may be subject to discipline by the Board.”

In plain language, the new regulations require doctors, nurses, social workers, counselors, and psychologists to use gender affirming care, and if they do not, they are subject to discipline against their license. 

For example, if a family whose child is struggling with gender issues wants to find a therapist who will not support the notion that a boy can become a girl or vice versa, if the therapist pursues that course of treatment, they could potentially lose their license.

Following the adoption of the new regulations, Shapiro applauded the changes in a press release.

“This decisive action makes clear that there is no place for the harmful, dangerous practice of conversion therapy here in our Commonwealth,” said Governor Josh Shapiro.

The release defines conversion therapy as “any practice that seeks or purports to change an individual’s sexual orientation or gender identity.” [emphasis added]

Last year, Shapiro, in his official capacity as Governor, furthered his commitment to gender affirming care by using taxpayer dollars to join a lawsuit against the Trump administration to reinstate gender surgeries for children.

Shapiro’s stance on gender affirming care stands in stark contrast to the majority of states in the country; however, he is fully aligned with Children’s Hospital of Pennsylvania (CHOP) — the only agency in the state still providing such services.

CHOP’s Gender and Sexuality Clinic not only continues to prescribe hormones and puberty blockers and perform sex change surgeries, it refuses to answer any questions or respond to requests for information.

Previously Broad + Liberty made eight requests for comment, requests for their annual reports, and a request to speak with an expert  — all to no avail.

CHOP’s clinic remains locked in secrecy, despite offering to supply annual reports if requested, according to their website.

It is heartening to see the tide turning on a practice that irreparably harms children; yet, it is discouraging to live in a state where the Governor and one of the largest pediatric healthcare providers continue to support gender affirming care — despite the vast evidence against it for minors.

Hopefully, more national associations and providers will have the courage, conviction, and ethics to issue similar statements to ASPS. As more groups decry this damaging practice, the sooner we can focus on getting these children the help they truly need.

Ultimately, whether for financial reasons or moral ones, it is in the best interest of our children and our society to end gender affirming care for minors.

Beth Ann Rosica resides in West Chester, has a Ph.D. in Education, and has dedicated her career to advocating on behalf of at-risk children and families. She covers education issues for Broad + Liberty. Contact her at barosica@broadandliberty.com.