Senator Marshall: Our Children Deserve Compassionate Care, Not Irreversible Medical Interventions

Senator Marshall Questions Witnesses at Senate HELP Committee Hearing

Washington - On Wednesday, U.S. Senator Roger Marshall, M.D. (R-Kansas), questioned witnesses Dr. Kurt Miceli, M.D., Chief Medical Officer of Do No Harm,and Chloe Cole, De-transitioner and advocate, at the Senate Health, Education, Labor, and Pensions committee hearing focused on exposing the dangers and irreversible gender transition procedures in minors.

As a practicing OB-GYN for more than 25 years, Senator Marshall sounded the alarm on the devastating long-term physical and psychological consequences of puberty blockers, cross-sex hormones, and irreversible surgeries performed on minors who are far too young to grasp the permanence of those decisions. He made clear throughout the hearing that children battling anxiety, depression, and other mental health struggles deserve genuine, compassionate care - not experimental interventions that rob them of a healthy future.

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Highlights from the hearing include:

Senator Marshall: "Well, thank you, Chairman, and I appreciate our guest today, Dr. Marcella. Like you, I practiced medicine for 25 years. I saw hundreds, maybe thousands, of adolescent girls. As you can imagine, when a mom or an aunt is bringing in their 13-, 15-, or 17-year-old daughter, there's usually something going on. A lot of it was related to STDs, pregnancy, family planning, and those types of issues. Many of those young ladies also had underlying challenges. I wouldn't necessarily classify them as mental illnesses, but there was anxiety, depression, suicidal ideation, and other similar concerns. But transgender issues - whether it was transition surgery or hormones - were never something anyone approached me about. What's different today? I was practicing up until about 10 years ago, and this seems like something relatively new. It seems like a fad. Do you have any insight into that?"

Dr. Miceli: "Thank you for the question, Senator. I think there's a lot we can look at in terms of the Dutch Protocol and the studies that came out in 2011 and 2014. Those studies were really developed in response to efforts to find ways of helping individuals who were seeking to transition. But I think the reality is that the evidence base today is quite different. As you've noted, there have been considerable changes over the past 10 years, particularly when you look at the influence of social media, the prevalence of comorbid psychiatric conditions, and the other challenges that many people face. One of the things we can't forget is the need to focus on those underlying conditions. If we look at a recent study out of Finland, for example, we see that during the period from 1996 to 2010, about 24 percent of the individuals who presented to a gender clinic had a comorbid psychiatric illness and were seeking psychiatric care. From 2010 to 2019, that number doubled to 48 percent. By comparison, among the control population, the rate was about 15 percent."

Senator Marshall: "Thanks. Certainly, we have a mental health epidemic among our youth. Ms. Cole, first of all, you're the bravest person I'm going to meet this week, and I want you to know that your willingness to testify is one of the most courageous things I've ever seen. Your testimony is very compelling. In fact, I think it's one of the most compelling testimonies I've heard in a long, long time. So, thank you for sharing your story. Can you help me understand something? Where did you first get the idea that being transgender was an option or a path for you? Go ahead."

Ms. Cole: "Thank you, Senator. I learned about transgenderism and the definition of the word transgenderthrough social media. It was primarily through groups of young people who were talking about different topics in the culture, from pop culture to politics. From there, I just kept learning about these ideas - that sex and gender are two separate things, that both exist on a spectrum, and that there are some people, even children, who are born in the wrong body because they feel uncomfortable with the changes that come with puberty. As a girl who was at a very uncomfortable point in her life - moving to a new school, being one of the first in my class to really start physically developing, and receiving attention that was focused on my body rather than on me as a human being - I thought maybe this was something that applied to me. Maybe I was a boy because I didn't like that discomfort. Maybe I wasn't just a tomboy; maybe I was actually transgender."

Senator Marshall: "Okay. Certainly, I want to express empathy as well, much like Senator Kaine did. We're not here to persecute anybody; we're here to help. But the studies would suggest that these irreversible surgeries and medical treatments do not necessarily address the underlying mental health challenges, and I think that is becoming increasingly well established. You know, my big concern as a grandfather, a father, and an OB-GYN is the irreversibility of these procedures, the potential side effects, and the issue of infertility. I took care of hundreds of women who had mastectomies as a result of breast cancer. Many of them suffered from lymphedema. They experienced swelling under their arms and chronic pain. I can only imagine the chronic pain and other complications that may result from some of the bottom surgeries. But infertility alone would be enough for me to pause and question allowing these procedures for minors. Ms. Cole, could you speak a little more about the informed consent process that you did or did not go through? Did anyone discuss the potential complications, the irreversibility, infertility, or those types of long-term consequences with you?"

Ms. Cole: "I do not believe that either I or my parents were properly informed of the consequences of these procedures. From the puberty-blocking drugs to the cross-sex hormones - of which I received increasingly large doses over the years - and the surgery itself, every one of those treatments has had lasting effects on my life. To this day, I am still suffering the consequences. It has been five or six years since I stopped these interventions, and I continue to experience chronic pain in my joints, my back, and my pelvis. I don't know whether I am at an increased risk of reproductive cancers, which is a known potential side effect of these treatments. I don't know if I will be able to have children of my own, which is part of the reason I detransitioned in the first place. When I was about 16 years old, I realized that one day I wanted to become a mother. I wanted to be able to have children of my own naturally, to get married, to become pregnant, to breastfeed my children, and to experience that beautiful bond. But all of that may have been taken away from me before I could even call myself a woman - before I was even an adult. Hearings like this are not part of some coordinated attack on people who experience discomfort around their gender. It is not hateful to question bad science or bad medical practices. We are simply looking out for the well-being of children who are not equipped to make permanent decisions and whose parents are often being told that they have no other choice."

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