It seems like every few months another headline arrives that pulls at the heartstrings, especially on a topic as emotionally charged as the medical treatment of children questioning their gender identity. The latest news set a clear tone: Tuesday’s announcement from the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) marked a sweeping policy shift, effectively cutting off federal Medicaid funding for youth sex-change treatments. For many, this was a political decision that sparked outrage and fear. But in certain doctor’s offices across the country, it was greeted with a sense of relief, maybe a little cautious hope, and even celebration. One of those doctors is Dr. Quentin Van Meter, a pediatric endocrinologist and the immediate past president of the American College of Pediatricians. With the calm of someone who has spent more than four decades in medicine, he says he walked away from the announcement feeling grateful. “I’m really congratulating HHS and CMS for taking a step to block the medical and surgical interventions or funding for those in those healthcare systems,” Van Meter told Fox News Digital, “primarily because it’s not an appropriate kind of intervention.”
For those who worry that this is an abandonment of children, the doctor’s words are meant to offer a radically different frame. He pushes back hard on the idea that these funding restrictions are a denial of care or that they mean the world is turning its back on kids with conflicting feelings about their bodies. “This is not denial of care. This is not lack of compassion. This is not denial that these patients exist,” he says, anticipating the criticism from advocates of gender transition. Instead, Van Meter calls the policy “very compassionate, very appropriate,” and points again to the kind of support that he believes these children need most: ongoing mental health treatment, not drugs and unnecessary surgeries. He has spent decades looking at the hormonal system, but after a fellowship at Johns Hopkins in the late 1970s, he carried a deep conviction that the body is a masterful product, not a mistake to be corrected. “Puberty is not a disease,” he insists. When you change the natural trajectory of puberty with the intention of making a child feel more like the opposite sex, the result, he argues, can actually make their mental health struggles worse, adding a whole new layer of confusion and physical burden to a young person who is already hurting.
Van Meter’s position is linked to a larger, growing pile of evidence that has begun to crack the ideological seal that once held the “gender-affirming” medical model in place. He points to a longtime cloud over an important study funded by the National Institutes of Health, beginning in 2015. Researchers set out to follow five years of youth use of sex-change hormones, but just two years into the study, the last two had three participants dying by suicide. That alone would seem to be a reason to hit the emergency brakes. Instead, according to Van Meter, the researchers continued and tried to become a safe behind-the-scenes attempt to bury the data, refusing to publish their own results if they didn’t paint the story they expected. The picture grew even darker when a GOP-led Senate committee looked at the project in 2024 and accused the investigative leaders of deliberately withholding evidence that showed these interventions did not actually help children’s mental health. The committee found that the same study had eleven kids reporting suicidal thoughts, a detail meant to be buried in the noise. For Van Meter, the saga is an example of a study made status, but not to protect children, and the funding community with a staked claim in continuing those treatments—a tooth that went sideways.
But this is all about one study. The entire framework of the child transition in this country has been their built upon questionable opinion presented as proof, something Van Meter calls “ideological.” He is particularly sharp about the influence of the World Professional Association for Transgender Health, known by the acronym WPATH, which has been the origin and hub of the medical guidelines that many major associations reflexively adopted. Now WPATH is facing a court challenge, in a Texas case, with the Federal Trade Commission, and the allegation that the guesswork was sold as data. “None of this is a standard of care, none of it is rigorous. It’s just their specific opinion based on their ideology,” Van Meter charges. And the harms, as he knows too well, are not cutting anywhere close to skin deep. Children and adolescents who move the button down the medical path are told they can find their true self, but in in reality they are opening the door to permanent sterilization, deep sexual dysfunction, damaged bone density that may struggle to rebuild, and an affected still mature brain—all while being set up for a lifetime of dependence on antibodies. He worries, too, about the list of detransitioners, all of which has discovered that their gender dysphoria was not the real pain, but the start of an entirely new ending of pain.
And if you remove the bulky belly and the padded blood motifs from the stories, what are you left with? In Van Meter’s experience, a creation of truly hurting children. The call to transition often arises at a moment when a child’s entire life is collapsing around them. He has seen it all: scripts dictated by the trauma of divorce, a parent behind bars, the heroin haze of a caregiver’s active addiction, or the shattering grief of a death in the family. These are children searching for an escape, and the internet offers a seductive solution. Influencers and anonymous communities say to them, “You are in your body is wrong, the core of your trouble is your gender and the answer is to change it.” It’s an irresistibly simple story that no longer needs the deeper pain. Not every child who has these thoughts will remain on the path. Van Meter has watched the detransition community grow, even in one year he spoke to 85 different people at a conference who came from across the world to try to undo what had been done to them. He has seen the messy, painful road back—reconstructive surgeries, uncomfortable weaning from medication that altered the shape of their body, and therapy to cling to the cellular wreckage of the life they once felt they had.
Where does this go from here? Van Meter isn’t content with simply stopping the wrong treatment. He wants to change the climate that allowed the unnecessary worry to bloom in the first place. He suggests yanking federal funding away from medical schools that promote sex-change research or that force students to practice these procedures as standard. It might seem drastic, but he argues that too many doctors are in the moment because they just are scared. If they speak up, they have incense as a “bigot” or a “hater”; if they write a competing voice into the literature, they get pinned off from academic departments; if they are alive in the professional associations, they become the problem, and then their careers suffer for it. To make things right for those who have already been hurt, Van Meter says the statute of limitations should be extended so that detransitioners can have their day in court against the old provider, and that all clinics should be forced to open their doors and show the scientific honesty they claimed to be. In the end, the old doctor expects something even simpler: the guts to ask a question that he has been asking for 42 years—why is this child hurting? He is comforted by the feeling that a national policy shift may finally put that asking ahead of the injection, and “compassion” may have a new meaning.
