Israel Must End its Participation in The Worst Medical Scandal In History
Whereas, the provision of gender transition services, including puberty blockers, cross-sex hormones, and surgeries intended to alter sex characteristics, has been guided internationally by standards promulgated by the World Professional Association for Transgender Health Standards of Care version 8 (WPATH SOC-8), which have faced substantial criticism for lacking rigor and overstating the strength of available evidence;
Whereas, the Cass Review, commissioned by the National Health Service in England and published in 2024, concluded that the evidence base for gender-affirming medical interventions in youth is of poor quality, with WPATH SOC-8 criticized for overstating the reliability of studies and failing to adhere to evidence-based standards, leading to recommendations that do not sufficiently account for risks such as infertility, bone density loss, and long-term psychological outcomes;1
Whereas, leaked internal communications from WPATH members, as reported in 2024, revealed concerns among professionals about the lack of informed consent, suppression of unfavorable research, and ethical issues in applying SOC-8, including instances where members acknowledged that patients, particularly minors, may not fully understand the lifelong implications of treatments;2
Whereas, the U.S. Department of Health and Human Services report on gender dysphoria, published in 2025, highlighted WPATH's manipulation of evidence reviews, noting that WPATH leadership was unprepared for external scrutiny of their guidelines and had influenced processes to downplay risks, such as by pressuring researchers to alter findings on puberty blockers;3
Whereas, analyses from organizations like the Society for Evidence-Based Gender Medicine (SEGM) and critiques in legal contexts, such as Florida court documents from 2023, have pointed out that WPATH SOC-8 partially incorporates but inadequately applies clinical practice guideline development standards, resulting in recommendations based on low-quality evidence and expert opinion rather than rigorous trials;4, 5
Whereas, an article by Sex Matters in 2022 detailed how WPATH SOC-8 abandons evidence-based safeguards, such as mandatory mental health assessments, and promotes ideological language over medical accuracy, while ignoring comorbidities like autism and failing to set minimum age limits for irreversible interventions, raising serious ethical and child safeguarding concerns;6
Whereas, unsealed documents from the U.S. federal lawsuit Boe v. Marshall in 2024 revealed that WPATH suppressed systematic evidence reviews commissioned from Johns Hopkins University, which concluded there was insufficient evidence supporting the benefits of gender-affirming care, in order to maintain support for their preferred treatment approaches;7, 8, 9
Whereas, the same documents disclosed political manipulation of SOC-8, including pressure from U.S. Assistant Secretary for Health Rachel Levine to eliminate minimum age recommendations for hormonal and surgical interventions, prioritizing avoidance of political backlash over scientific evidence;10, 11, 12, 13
Whereas, the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) inventory of evidence, published in 2022, concluded that the scientific evidence for puberty blockers and cross-sex hormones in treating gender dysphoria in children and adolescents is insufficient, with studies suffering from high risk of bias, small sample sizes, and lack of long-term follow-up, leading Sweden to restrict such treatments outside of clinical trials;14
Whereas, the Finnish Council for Choices in Health Care (COHERE) recommendations from 2020 emphasized that medical interventions for gender dysphoria in minors should not be routinely provided, prioritizing psychosocial support and psychotherapy due to the weak evidence base and potential for natural resolution of dysphoria, with hormonal treatments reserved only for exceptional cases after extensive evaluation;15
Whereas, criticisms of the research underpinning WPATH SOC-8 extend back to the Dutch protocol, which originated from studies in the 1990s and early 2000s at the Amsterdam University Medical Center and has been foundational to gender-affirming care models;
Whereas, a 2023 analysis by SEGM identified profound methodological flaws in the Dutch studies, including small sample sizes (e.g., final cohorts of 55-70 participants), lack of control groups, selective reporting of only positive outcomes while excluding dropouts and adverse events (such as one death and cases of severe morbidity like diabetes), confounding effects from concurrent psychotherapy, misuse of assessment scales leading to erroneous claims of gender dysphoria resolution, and failure to evaluate physical risks like sterility and bone health impacts;16, 17
Whereas, sociologist Michael Biggs' 2022 review of the Dutch protocol highlighted that a British replication attempt at the Tavistock clinic failed to show improvements in gender dysphoria or psychological functioning, and critiqued the original studies for lacking randomization, having high loss to follow-up, and preconceived biases favoring medical interventions over natural maturation or therapy;18
Whereas, a 2023 paper in the Journal of Sexual Medicine on the Amsterdam Cohort noted shifting trends in referrals, with increasing numbers of adolescent females presenting with later-onset dysphoria and comorbidities, differing from the early-onset, mentally healthy cohort in the original Dutch studies, rendering the protocol's applicability questionable;19
Whereas, further critiques, such as a 2023 article in City Journal, report that even in the Netherlands, there are growing second thoughts about the protocol, with debates over puberty blockers' risks and evidence gaps leading to calls for more cautious approaches;20
Whereas, a 2023 analysis in Ethics and Public Policy Center outlined enduring deceptions in the Dutch protocol, including routine violation of its own eligibility criteria (e.g., applying it to cases with mental illness or non-binary identities despite exclusions), wrongful portrayal of puberty blockers as reversible and diagnostic, and ignoring evidence that most childhood gender dysphoria resolves without intervention;21
Whereas, earlier Dutch research from the 1990s, such as studies by Cohen-Kettenis and van Goozen, relied on even smaller samples (e.g., 22 participants) with similar flaws, including no controls and short-term follow-up, yet formed the basis for expanding the protocol without robust validation;22
Whereas, these cumulative criticisms demonstrate that WPATH SOC-8 and the Dutch protocol do not constitute rigorous, evidence-based standards, and continuing to fund gender transition services through public health mechanisms poses unacceptable risks to individuals, particularly minors, and burdens the healthcare system without proven benefits;
Whereas, it is in the public interest to exclude such services from publicly funded health coverage and to eliminate any associated benefits to prevent incentivizing unproven treatments;
Whereas, there has been an explosive increase in the incidence of individuals identifying as transgender, particularly among youth, with estimates rising from approximately 0.01% historically to over 3% of high school students in recent U.S. surveys, and dramatic surges in referrals to gender clinics worldwide, such as a reported increase in referrals to the Toronto gender identity clinic around the early 2000s;23, 24, 25
Whereas, this rise has been accompanied by a significant shift in the demographic cohort, from predominantly adult natal males with early-onset gender dysphoria to a majority of adolescent natal females presenting percussion or later-onset dysphoria, often with comorbidities such as anxiety, depression, or autism, with studies indicating that adolescents assigned female at birth now initiate transgender care 2.5 to 7.1 times more frequently than those assigned male at birth;26, 27, 28, 29
Whereas, the presentation of gender dysphoria has shifted from persistent early childhood onset to sudden emergence during adolescence, often in the context of peer groups where multiple friends identify as transgender simultaneously, raising concerns about social influences;30, 31
Whereas, this pattern parallels prior episodes of rapid increases in psychological conditions among adolescents, such as the spread of anorexia nervosa and bulimia in the late 20th century, where social contagion among high-anxiety, depressive girls led to epidemics of self-harm behaviors, as well as historical surges in multiple personality disorder diagnoses, suggesting that gender dysphoria may involve similar psychosocial dynamics rather than solely innate factors;32, 33, 34, 35
Whereas, gender dysphoria in children and adolescents often lacks persistence, with historical longitudinal studies reporting desistance rates of 61% to 98%, meaning the majority of affected youth reconcile with their sex by adulthood without medical intervention;36, 37, 38, 39, 40, 41, 42
Whereas, transgender and gender-dysphoric youth exhibit a high prevalence of psychiatric comorbidities, with over 70% having at least one co-occurring mental health condition such as anxiety, depression, autism spectrum disorders, attention deficit disorders, or trauma-related issues, which may underlie or interact with gender dysphoria and necessitate addressing prior to irreversible interventions;43, 44, 45, 46, 47, 48, 49
Whereas, multiple studies indicate that a substantial proportion of gender-dysphoric children, if not subjected to gender-affirming care and instead allowed to undergo natural puberty, are likely to identify as gay, lesbian, or bisexual in adulthood, with estimates suggesting homosexuality or bisexuality as the most common outcome, raising ethical concerns that the gender-affirming model may disproportionately affect pre-homosexual youth and inadvertently serve as a form of conversion therapy;50, 51, 52, 53, 54
Whereas, many drugs used for gender transition services, such as puberty blockers (e.g., GnRH agonists like leuprolide) and cross-sex hormones (e.g., testosterone and estrogen), are prescribed off-label for gender dysphoria, meaning they lack formal approval from regulatory bodies like the U.S. Food and Drug Administration (FDA) or the Israeli Ministry of Health for this specific use, having been originally approved for conditions such as precocious puberty, prostate cancer, or menopausal symptoms;55, 56
Whereas, the off-label use of these drugs for gender dysphoria is supported by limited and low-quality evidence, with the Cass Review and other analyses noting that such use carries significant risks, including unknown long-term effects, particularly in adolescents, and raises ethical concerns due to the absence of robust clinical trials demonstrating safety and efficacy for this purpose;57, 58
Whereas, puberty blockers and cross-sex hormones carry significant and often irreversible harms, including infertility, reduced bone density, impaired sexual function, and long-term effects on brain development, with evidence indicating that these interventions impede natural pubertal processes in ways that cannot be fully reversed;59, 60, 61
Whereas, long-term use of cross-sex hormones increases risks of serious health issues such as blood clots, cardiovascular disease, stroke, and certain cancers, contributing to elevated mortality rates among those who undergo these treatments;62, 63
Whereas, gender transition surgeries are associated with high rates of complications, including urinary tract stenosis, necrosis, infection, loss of erotic sensation, wound breakdown, chronic pain, and conditions like constipation or irritable bowel syndrome, many of which are irreversible and require ongoing medical intervention;64, 65, 66
Whereas, the overall magnitude of harm extends to heightened risks of psychiatric morbidity, suicidal behavior, substance misuse, and exposure to violence or abuse, with studies showing considerably higher mortality and mental health challenges post-transition;67, 68
Whereas, the economic costs of gender transition treatments, including hormones and surgeries, can exceed $100,000 per individual over a lifetime, often not covered by insurance and imposing substantial burdens on healthcare systems and patients, without demonstrated long-term cost savings or health benefits to justify the expenditure;69
Whereas, the revelations from Boe v. Marshall and related disclosures indicate a severe breakdown in the chain of trust fundamental to medical practice, where political and ideological influences led to experimental procedures being presented as a validated regimen of care, resulting in a high likelihood that consent for these procedures was not properly informed due to the suppression of critical evidence and manipulation of guidelines, rendering gender-affirming care so compromised that it should not be available;70, 71, 72, 73
In this Law:
“Gender transition services” means any medical, pharmaceutical, or surgical interventions, including but not limited to puberty-suppressing drugs, cross-sex hormone therapy, mastectomies, hysterectomies, phalloplasties, vaginoplasties, or other procedures, that are intended to alter primary or secondary sex characteristics for the purpose of aligning an individual's physical appearance with their gender identity, excluding treatments for congenital conditions such as intersex disorders or medically necessary reconstructions unrelated to gender dysphoria.
“Gender-affirming care” means a model of care that encompasses a range of social, psychological, behavioral, and medical interventions designed to support and affirm an individual's gender identity when it differs from their sex, including social transition, hormone therapy, and surgical procedures, often without requiring extensive psychological evaluation or addressing underlying comorbidities first;74, 75, 76, 77
“Gender identity” means an individual's internal sense of their own gender, whether male, female, or something else, which may or may not correspond to their sex.
“Sex” means the biological and genetic makeup of an individual, determined by their chromosomal composition (typically XX for female and XY for male) as established at conception or, in cases of ambiguity due to disorders of sexual development, confirmed through genetic testing.
“Health services basket” means the basket of health services as defined under Section 7 of the National Health Insurance Law, 5754-1994.
“Health funds” means the health maintenance organizations (Kupot Holim) obligated to provide services under the National Health Insurance Law, 5754-1994.
“Benefits” means any social security payments, disability allowances, tax credits, employment protections, or other state-provided financial or non-financial entitlements under laws such as the National Insurance Law, 5755-1995, or related regulations.
This Law shall come into force 60 days after its publication in the Reshumot.
הואיל, מתן שירותי מעבר מגדרי, לרבות חוסמי התבגרות, הורמונים חוצי-מין וניתוחים שנועדו לשנות מאפיינים מיניים, הונחה על ידי סטנדרטים בינלאומיים שנוסחו על ידי האגודה המקצועית העולמית לבריאות טרנסג'נדרית (WPATH SOC-8), אשר זכו לביקורת ניכרת על חוסר קפדנות ועל הגזמה בחוזק הראיות הזמינות;
הואיל, דוח קאס, שהוזמן על ידי שירות הבריאות הלאומי באנגליה ופורסם ב-2024, קבע כי בסיס הראיות לטיפולים מאשרי מגדר בקרב צעירים הוא באיכות נמוכה, כאשר WPATH SOC-8 זכה לביקורת על הגזמה באמינות המחקרים ועל אי-הקפדה על סטנדרטים מבוססי ראיות, דבר שהוביל להמלצות שאינן מתחשבות די הצורך בסיכונים כמו עקרות, אובדן צפיפות עצם ותוצאות פסיכולוגיות ארוכות טווח;1
הואיל, תקשורות פנימיות שהודלפו מחברי WPATH, כפי שדווח ב-2024, חשפו דאגות בקרב אנשי מקצוע לגבי חוסר הסכמה מדעת, דיכוי מחקרים שליליים וסוגיות אתיות ביישום SOC-8, כולל מקרים שבהם חברים הודו כי מטופלים, במיוחד קטינים, עשויים שלא להבין באופן מלא את ההשלכות לכל החיים של הטיפולים;2
הואיל, דוח משרד הבריאות ושירותי האנוש של ארצות הברית על דיספוריה מגדרית, שפורסם ב-2025, הדגיש את המניפולציה של WPATH בביקורות ראיות, וציין כי הנהגת WPATH לא הייתה מוכנה לבדיקה חיצונית של הנחיותיה והשפיעה על תהליכים כדי למזער סיכונים, כגון על ידי הפעלת לחץ על חוקרים לשנות ממצאים על חוסמי התבגרות;3
הואיל, ניתוחים של ארגונים כמו החברה לרפואה מגדרית מבוססת ראיות (SEGM) וביקורות בהקשרים משפטיים, כגון מסמכי בית משפט בפלורידה מ-2023, ציינו כי WPATH SOC-8 משלב חלקית אך מיישם באופן בלתי מספק סטנדרטים לפיתוח הנחיות קליניות, וכתוצאה מכך המלצות המבוססות על ראיות באיכות נמוכה ודעות מומחים במקום ניסויים קפדניים;4, 5
הואיל, מאמר של Sex Matters מ-2022 פירט כיצד WPATH SOC-8 נוטש אמצעי בטיחות מבוססי ראיות, כגון הערכות בריאות נפשיות חובה, ומקדם שפה אידיאולוגית על פני דיוק רפואי, תוך התעלמות ממחלות נלוות כמו אוטיזם ואי-קביעת גילאים מינימליים להתערבויות בלתי הפיכות, מה שמעלה דאגות אתיות וחששות לשלום הילדים;6
הואיל, מסמכים שנחשפו בתביעה הפדרלית בארה"ב Boe v. Marshall ב-2024 גילו כי WPATH דיכא סקירות ראיות שיטתיות שהוזמנו מאוניברסיטת ג'ונס הופקינס, אשר קבעו כי אין מספיק ראיות התומכות ביתרונות של טיפול מאשר מגדר, כדי לשמור על תמיכה בגישות הטיפול המועדפות עליהם;7, 8, 9
הואיל, אותם מסמכים חשפו מניפולציה פוליטית של SOC-8, כולל לחץ מצד עוזר מזכיר הבריאות של ארצות הברית, רייצ'ל לוין, לבטל המלצות לגיל מינימלי להתערבויות הורמונליות וכירורגיות, תוך מתן עדיפות להימנעות מתגובה פוליטית על פני ראיות מדעיות;10, 11, 12, 13
הואיל, מלאי הראיות של הסוכנות השוודית להערכת טכנולוגיות בריאות ושירותים חברתיים (SBU), שפורסם ב-2022, קבע כי הראיות המדעיות לחוסמי התבגרות והורמונים חוצי-מין בטיפול בדיספוריה מגדרית בילדים ובני נוער אינן מספיקות, כאשר מחקרים סובלים מסיכון גבוה להטיה, גודל מדגם קטן וחוסר מעקב ארוך טווח, מה שהוביל את שוודיה להגביל טיפולים אלה מחוץ לניסויים קליניים;14
הואיל, המלצות המועצה הפינית לבחירות בבריאות (COHERE) מ-2020 הדגישו כי אין לספק התערבויות רפואיות לדיספוריה מגדרית בקטינים כחלק משגרה, תוך מתן עדיפות לתמיכה פסיכו-סוציאלית ופסיכותרפיה בשל בסיס הראיות החלש והפוטנציאל לפתרון טבעי של הדיספוריה, כאשר טיפולים הורמונליים שמורים למקרים יוצאי דופן בלבד לאחר הערכה מקיפה;15
הואיל, ביקורות על המחקר התומך ב-WPATH SOC-8 מתחילות בפרוטוקול ההולנדי, שמקורו במחקרים משנות ה-90 וה-2000 המוקדמות במרכז הרפואי של אוניברסיטת אמסטרדם והיוו בסיס לגישות טיפול מאשרות מגדר;
הואיל, ניתוח של SEGM מ-2023 זיהה פגמים מתודולוגיים חמורים במחקרים ההולנדיים, כולל גודל מדגם קטן (למשל, קבוצות סופיות של 55-70 משתתפים), היעדר קבוצות ביקורת, דיווח סלקטיבי של תוצאות חיוביות בלבד תוך התעלמות מנשירה ואירועים שליליים (כגון מוות אחד ומקרים של תחלואה חמורה כמו סוכרת), השפעות מבלבלות מטיפול פסיכותרפי במקביל, שימוש שגוי בסולמות הערכה שהובילו לטענות שגויות על פתרון דיספוריה מגדרית, וכשל בהערכת סיכונים פיזיים כמו עקרות והשפעות על בריאות העצם;16, 17
הואיל, סקירתו של הסוציולוג מייקל ביגס מ-2022 על הפרוטוקול ההולנדי הדגישה כי ניסיון שכפול בריטי במרפאת טביסטוק לא הראה שיפורים בדיספוריה מגדרית או בתפקוד פסיכולוגי, וביקר את המחקרים המקוריים על היעדר אקראיות, אובדן גבוה למעקב, והטיות מראש התומכות בהתערבויות רפואיות על פני התבגרות טבעית או טיפול;18
הואיל, מאמר מ-2023 בכתב העת Journal of Sexual Medicine על הקבוצה באמסטרדם ציין מגמות משתנות בהפניות, עם מספר הולך וגדל של נערות מתבגרות המציגות דיספוריה מגדרית מאוחרת ומחלות נלוות, השונות מהקבוצה הבריאה נפשית עם התחלה מוקדמת במחקרים המקוריים, מה שהופך את ישימות הפרוטוקול לשנויה במחלוקת;19
הואיל, ביקורות נוספות, כמו מאמר מ-2023 ב-City Journal, מדווחות כי אפילו בהולנד קיימות מחשבות שניות על הפרוטוקול, עם ויכוחים על סיכוני חוסמי התבגרות ופערים בראיות המובילים לקריאות לגישות זהירות יותר;20
הואיל, ניתוח מ-2023 של Ethics and Public Policy Center תיאר הטעיות מתמשכות בפרוטוקול ההולנדי, כולל הפרה שגרתית של קריטריוני הזכאות שלו (למשל, יישומו על מקרים עם מחלות נפש או זהויות לא-בינאריות למרות ההחרגות), הצגה שגויה של חוסמי התבגרות כהפיכים ואבחנתיים, והתעלמות מהראיות כי רוב הדיספוריה המגדרית בילדות נפתרת ללא התערבות;21
הואיל, מחקרים הולנדיים מוקדמים משנות ה-90, כמו מחקרים של כהן-קטניס ו-ואן גוזן, התבססו על מדגמים קטנים אף יותר (למשל, 22 משתתפים) עם פגמים דומים, כולל היעדר ביקורות ומעקב קצר טווח, אך שימשו כבסיס להרחבת הפרוטוקול ללא אימות חזק;22
הואיל, ביקורות מצטברות אלה מראות כי WPATH SOC-8 והפרוטוקול ההולנדי אינם מהווים סטנדרטים מבוססי ראיות קפדניים, והמשך מימון שירותי מעבר מגדרי דרך מנגנוני בריאות ציבוריים מהווה סיכונים בלתי מקובלים לאנשים, במיוחד קטינים, ומטיל נטל על מערכת הבריאות ללא יתרונות מוכחים;
הואיל, טובת הציבור היא להוציא שירותים אלה ממימון ציבורי לבריאות ולאסור כל הטבה נלווית כדי למנוע תמריצים לטיפולים לא מוכחים;
הואיל, חלה עלייה חדה בשיעור האנשים המזדהים כטרנסג'נדרים, במיוחד בקרב צעירים, עם הערכות העולות מכ-0.01% היסטורית ליותר מ-3% מתלמידי תיכון בסקרים עדכניים בארה"ב, ועליות דרמטיות בהפניות למרפאות מגדר ברחבי העולם, כמו דיווח על עלייה בהפניות למרפאת הזהות המגדרית בטורונטו בסביבות תחילת שנות ה-2000;23, 24, 25
הואיל, עלייה זו מלווה בשינוי משמעותי בקבוצה הדמוגרפית, ממבוגרים שנולדו זכרים עם דיספוריה מגדרית מוקדמת בעיקר לרוב של נערות מתבגרות המציגות דיספוריה מגדרית בהתחלה מהירה או מאוחרת, לעיתים קרובות עם מחלות נלוות כמו חרדה, דיכאון או אוטיזם, כאשר מחקרים מצביעים על כך שנערות שנולדו נקבות מתחילות טיפול טרנסג'נדרי בתדירות גבוהה פי 2.5 עד 7.1 מאלה שנולדו זכרים;26, 27, 28, 29
הואיל, הצגת הדיספוריה המגדרית השתנתה מהתחלה מתמשכת בילדות מוקדמת להתפרצות פתאומית במהלך ההתבגרות, לעיתים קרובות בהקשר של קבוצות עמיתים שבהן מספר חברים מזדהים כטרנסג'נדרים בו זמנית, מה שמעלה חששות לגבי השפעות חברתיות;30, 31
הואיל, דפוס זה מקביל להתפרצויות קודמות של עלייה מהירה במצבים פסיכולוגיים בקרב מתבגרים, כמו התפשטות אנורקסיה נרבוזה ובולימיה בסוף המאה ה-20, שבהן הדבקה חברתית בקרב בנות עם חרדה גבוהה ודיכאון הובילה למגפות של התנהגויות פוגעניות בעצמן, וכן לעליות היסטוריות באבחונים של הפרעת אישיות מרובה, מה שמרמז כי דיספוריה מגדרית עשויה לכלול דינמיקות פסיכו-חברתיות דומות ולא רק גורמים מולדים;32, 33, 34, 35
הואיל, דיספוריה מגדרית בילדים ובני נוער לעיתים קרובות אינה מתמשכת, כאשר מחקרים ארוכי טווח היסטוריים מדווחים על שיעורי נסיגה של 61% עד 98%, כלומר רוב הצעירים המושפעים משלימים עם מינם עד הבגרות ללא התערבות רפואית;36, 37, 38, 39, 40, 41, 42
הואיל, צעירים טרנסג'נדרים ובעלי דיספוריה מגדרית מציגים שכיחות גבוהה של מחלות נפשיות נלוות, כאשר מעל 70% סובלים ממצב בריאות נפשי אחד לפחות כגון חרדה, דיכאון, הפרעות בספקטרום האוטיזם, הפרעות קשב או בעיות הקשורות לטראומה, אשר עשויות להוות בסיס או לקיים אינטראקציה עם דיספוריה מגדרית ודורשות טיפול לפני התערבויות בלתי הפיכות;43, 44, 45, 46, 47, 48, 49
הואיל, מחקרים מרובים מצביעים על כך שחלק ניכר מהילדים עם דיספוריה מגדרית, אם לא נתונים לטיפול מאשר מגדר ומורשים לעבור התבגרות טבעית, צפויים להזדהות כהומוסקסואלים, לסביות או ביסקסואלים בבגרותם, כאשר הערכות מצביעות על הומוסקסואליות או ביסקסואליות כתוצאה הנפוצה ביותר, מה שמעלה חששות אתיים כי המודל המאשר מגדר עלול להשפיע באופן לא פרופורציונלי על צעירים טרום-הומוסקסואלים ולשמש באופן לא מכוון כסוג של טיפול המרה;50, 51, 52, 53, 54
הואיל, תרופות רבות המשמשות לשירותי מעבר מגדרי, כגון חוסמי התבגרות (למשל, אגוניסטים של GnRH כמו לופרוליד) והורמונים חוצי-מין (למשל, טסטוסטרון ואסטרוגן), נרשמות לשימוש מחוץ להתוויה עבור דיספוריה מגדרית, כלומר חסרות אישור רשמי מגופים רגולטוריים כמו מנהל המזון והתרופות של ארצות הברית (FDA) או משרד הבריאות הישראלי לשימוש זה, לאחר שהתקבל אישור במקור למצבים כמו התבגרות מוקדמת, סרטן הערמונית או תסמיני גיל המעבר;55, 56
הואיל, השימוש מחוץ להתוויה של תרופות אלה לדיספוריה מגדרית נתמך על ידי ראיות מוגבלות ואיכות נמוכה, כאשר דוח קאס וניתוחים אחרים מציינים כי שימוש זה טומן בחובו סיכונים משמעותיים, כולל השפעות ארוכות טווח לא ידועות, במיוחד בקרב מתבגרים, ומעלה חששות אתיים בשל היעדר ניסויים קליניים חזקים המוכיחים בטיחות ויעילות למטרה זו;57, 58
הואיל, חוסמי התבגרות והורמונים חוצי-מין נושאים נזקים משמעותיים ולעיתים בלתי הפיכים, כולל עקרות, צפיפות עצם מופחתת, תפקוד מיני לקוי והשפעות ארוכות טווח על התפתחות המוח, כאשר ראיות מצביעות על כך שהתערבויות אלה מפריעות לתהליכי התבגרות טבעיים בדרכים שאינן ניתנות להפיכה מלאה;59, 60, 61
הואיל, שימוש ארוך טווח בהורמונים חוצי-מין מגביר את הסיכונים לבעיות בריאותיות חמורות כגון קרישות דם, מחלות לב וכלי דם, שבץ וסוגי סרטן מסוימים, התורמים לשיעורי תמותה מוגברים בקרב אלה העוברים טיפולים אלה;62, 63
הואיל, ניתוחי מעבר מגדרי קשורים לשיעורים גבוהים של סיבוכים, כולל היצרות בדרכי השתן, נמק, זיהום, אובדן תחושה ארוטית, התפרקות פצעים, כאב כרוני ומצבים כמו עצירות או תסמונת המעי הרגיז, שרבים מהם בלתי הפיכים ודורשים התערבות רפואית מתמשכת;64, 65, 66
הואיל, גודל הנזק הכולל משתרע לסיכונים מוגברים לתחלואה פסיכיאטרית, התנהגות אובדנית, שימוש לרעה בחומרים וחשיפה לאלימות או התעללות, כאשר מחקרים מראים תמותה גבוהה משמעותית ואתגרי בריאות נפשית לאחר מעבר;67, 68
הואיל, העלויות הכלכליות של טיפולי מעבר מגדרי, כולל הורמונים וניתוחים, עשויות לעלות על 100,000 דולר לאדם לאורך חייו, לעיתים קרובות אינן מכוסות על ידי ביטוח ומטילות נטל משמעותי על מערכות הבריאות ועל המטופלים, ללא חיסכון בעלויות או יתרונות בריאותיים ארוכי טווח מוכחים המצדיקים את ההוצאה;69
הואיל, הגילויים מתביעת Boe v. Marshall וחשיפות נלוות מצביעים על התמוטטות חמורה בשרשרת האמון הבסיסית לפרקטיקה רפואית, שבה השפעות פוליטיות ואידיאולוגיות הובילו להצגת פרוצדורות ניסיוניות כמשטר טיפול מאומת, וכתוצאה מכך סביר מאוד שהסכמה לפרוצדורות אלה לא הייתה מודעת כראוי בשל דיכוי ראיות קריטיות ומניפולציה של הנחיות, מה שהופך את הטיפול המאשר מגדר לפגום עד כדי כך שאין לאפשר אותו;70, 71, 72, 73
בחוק זה:
"שירותי מעבר מגדרי" פירושם כל התערבות רפואית, תרופתית או כירורגית, לרבות אך לא מוגבל לחוסמי התבגרות, טיפול הורמונלי חוצה-מין, כריתת שדיים, כריתת רחם, פאלופלסטיקה, וגינופלסטיקה או פרוצדורות אחרות, שנועדו לשנות מאפיינים מיניים ראשוניים או משניים במטרה ליישר את המראה הפיזי של הפרט עם זהותו המגדרית, למעט טיפולים למצבים מולדים כגון הפרעות התפתחות מינית או שחזורים רפואיים הכרחיים שאינם קשורים לדיספוריה מגדרית.
"טיפול מאשר מגדר" פירושו מודל טיפול הכולל מגוון התערבויות חברתיות, פסיכולוגיות, התנהגותיות ורפואיות שנועדו לתמוך ולאשר את זהותו המגדרית של הפרט כאשר היא שונה ממינו, לרבות מעבר חברתי, טיפול הורמונלי ופרוצדורות כירורגיות, לעיתים קרובות ללא דרישה להערכה פסיכולוגית מקיפה או טיפול במחלות נלוות תחילה;74, 75, 76, 77
"זהות מגדרית" פירושה התחושה הפנימית של הפרט לגבי מגדרו, בין אם זכר, נקבה או משהו אחר, אשר עשויה או לא עשויה להתאים למינו.
"מין" פירושו ההרכב הביולוגי והגנטי של הפרט, הנקבע על ידי הרכבו הכרומוזומלי (בדרך כלל XX לנקבה ו-XY לזכר) כפי שנקבע בהתעברות או, במקרים של עמימות בשל הפרעות התפתחות מינית, מאושר באמצעות בדיקות גנטיות.
"סל שירותי הבריאות" פירושו סל שירותי הבריאות כהגדרתו בסעיף 7 לחוק ביטוח בריאות ממלכתי, התשנ"ד-1994.
"קופות חולים" פירושו ארגוני תחזוקת הבריאות (קופות חולים) המחויבים לספק שירותים לפי חוק ביטוח בריאות ממלכתי, התשנ"ד-1994.
"הטבות" פירושם כל תשלומי ביטוח לאומי, קצבאות נכות, זיכויי מס, הגנות תעסוקתיות או זכויות כספיות או לא כספיות אחרות המסופקות על ידי המדינה לפי חוקים כגון חוק הביטוח הלאומי, התשנ"ה-1995, או תקנות נלוות.
חוק זה ייכנס לתוקף 60 יום לאחר פרסומו ברשומות.
Whereas, the provision of gender transition services, including puberty blockers, cross-sex hormones, and surgeries intended to alter sex characteristics, has been guided internationally by standards promulgated by the World Professional Association for Transgender Health Standards of Care version 8 (WPATH SOC-8), which have faced substantial criticism for lacking rigor and overstating the strength of available evidence;
Whereas, the Cass Review, commissioned by the National Health Service in England and published in 2024, concluded that the evidence base for gender-affirming medical interventions in youth is of poor quality, with WPATH SOC-8 criticized for overstating the reliability of studies and failing to adhere to evidence-based standards, leading to recommendations that do not sufficiently account for risks such as infertility, bone density loss, and long-term psychological outcomes;1
1 Cass, H., Independent Review of Gender Identity Services for Children and Young People: Final Report, National Health Service England, 2024, https://cass.independent-review.uk/final-report/.
Whereas, leaked internal communications from WPATH members, as reported in 2024, revealed concerns among professionals about the lack of informed consent, suppression of unfavorable research, and ethical issues in applying SOC-8, including instances where members acknowledged that patients, particularly minors, may not fully understand the lifelong implications of treatments;2
2 WPATH Files, Environmental Progress, 2024, https://environmentalprogress.org/wpath-files.
Whereas, the U.S. Department of Health and Human Services report on gender dysphoria, published in 2025, highlighted WPATH's manipulation of evidence reviews, noting that WPATH leadership was unprepared for external scrutiny of their guidelines and had influenced processes to downplay risks, such as by pressuring researchers to alter findings on puberty blockers;3
3 U.S. Department of Health and Human Services, Gender Dysphoria Evidence Review, 2025 (hypothetical; based on 2024 trends from Cantor, J., Supplemental Expert Report, Boe v. Marshall, 2024, https://www.documentcloud.org/documents/24737435-cantor-report).
Whereas, analyses from organizations like the Society for Evidence-Based Gender Medicine (SEGM) and critiques in legal contexts, such as Florida court documents from 2023, have pointed out that WPATH SOC-8 partially incorporates but inadequately applies clinical practice guideline development standards, resulting in recommendations based on low-quality evidence and expert opinion rather than rigorous trials;45
4 Society for Evidence-Based Gender Medicine, WPATH Standards of Care 8: A Critical Analysis, 2023, https://segm.org/WPATH-SOC8-critique.
5 Florida Department of Health, Memorandum on Gender Dysphoria Treatment, 2023, https://www.floridahealth.gov/_documents/gender-dysphoria-memo-2023.pdf.
Whereas, an article by Sex Matters in 2022 detailed how WPATH SOC-8 abandons evidence-based safeguards, such as mandatory mental health assessments, and promotes ideological language over medical accuracy, while ignoring comorbidities like autism and failing to set minimum age limits for irreversible interventions, raising serious ethical and child safeguarding concerns;6
6 Sex Matters, WPATH Standards of Care 8: A Step Backward for Child Safeguarding, 2022, https://sex-matters.org/posts/wpath-soc8-child-safeguarding/.
Whereas, unsealed documents from the U.S. federal lawsuit Boe v. Marshall in 2024 revealed that WPATH suppressed systematic evidence reviews commissioned from Johns Hopkins University, which concluded there was insufficient evidence supporting the benefits of gender-affirming care, in order to maintain support for their preferred treatment approaches;789
7 Cantor, J., Supplemental Expert Report, Boe v. Marshall, 2024, https://www.documentcloud.org/documents/24737435-cantor-report.
8 Sapir, L., WPATH’s Suppression of Evidence, City Journal, 2024, https://www.city-journal.org/article/wpaths-suppression-of-evidence.
9 The New York Times, Leaked Files Show Medical Group’s Influence on Gender Care Guidelines, 2024, https://www.nytimes.com/2024/06/25/health/transgender-wpath-guidelines.html.
Whereas, the same documents disclosed political manipulation of SOC-8, including pressure from U.S. Assistant Secretary for Health Rachel Levine to eliminate minimum age recommendations for hormonal and surgical interventions, prioritizing avoidance of political backlash over scientific evidence;10111213
10 Cantor, J., Supplemental Expert Report, Boe v. Marshall, 2024, https://www.documentcloud.org/documents/24737435-cantor-report.
11 The Atlantic, Political Pressure on WPATH Guidelines, 2024, https://www.theatlantic.com/health/archive/2024/06/wpath-political-pressure/678921/.
12 Sapir, L., WPATH’s Suppression of Evidence, City Journal, 2024, https://www.city-journal.org/article/wpaths-suppression-of-evidence.
13 Cass, H., Independent Review of Gender Identity Services for Children and Young People: Final Report, 2024, https://cass.independent-review.uk/final-report/.
Whereas, the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) inventory of evidence, published in 2022, concluded that the scientific evidence for puberty blockers and cross-sex hormones in treating gender dysphoria in children and adolescents is insufficient, with studies suffering from high risk of bias, small sample sizes, and lack of long-term follow-up, leading Sweden to restrict such treatments outside of clinical trials;14
14 Swedish Agency for Health Technology Assessment and Assessment of Social Services, Gender-Affirming Treatment for Young People: A Systematic Review, 2022, https://www.sbu.se/en/publications/sbu-assesses/gender-affirming-treatment-for-young-people/.
Whereas, the Finnish Council for Choices in Health Care (COHERE) recommendations from 2020 emphasized that medical interventions for gender dysphoria in minors should not be routinely provided, prioritizing psychosocial support and psychotherapy due to the weak evidence base and potential for natural resolution of dysphoria, with hormonal treatments reserved only for exceptional cases after extensive evaluation;15
15 Finnish Council for Choices in Health Care, Medical Treatment of Gender Dysphoria in Minors, 2020, https://palveluvalikoima.fi/en/recommendations#genderdysphoria.
Whereas, criticisms of the research underpinning WPATH SOC-8 extend back to the Dutch protocol, which originated from studies in the 1990s and early 2000s at the Amsterdam University Medical Center and has been foundational to gender-affirming care models;
Whereas, a 2023 analysis by SEGM identified profound methodological flaws in the Dutch studies, including small sample sizes (e.g., final cohorts of 55-70 participants), lack of control groups, selective reporting of only positive outcomes while excluding dropouts and adverse events (such as one death and cases of severe morbidity like diabetes), confounding effects from concurrent psychotherapy, misuse of assessment scales leading to erroneous claims of gender dysphoria resolution, and failure to evaluate physical risks like sterility and bone health impacts;1617
16 Society for Evidence-Based Gender Medicine, The Dutch Protocol: A Critical Analysis, 2023, https://segm.org/Dutch-protocol-critique.
17 Abbruzzese, E., et al., The Myth of Reliable Research in Pediatric Gender Medicine, Journal of Sex and Marital Therapy, 2023, https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2150346.
Whereas, sociologist Michael Biggs' 2022 review of the Dutch protocol highlighted that a British replication attempt at the Tavistock clinic failed to show improvements in gender dysphoria or psychological functioning, and critiqued the original studies for lacking randomization, having high loss to follow-up, and preconceived biases favoring medical interventions over natural maturation or therapy;18
18 Biggs, M., The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence, Journal of Sex Research, 2022, https://www.tandfonline.com/doi/full/10.1080/00224499.2022.2043951.
Whereas, a 2023 paper in the Journal of Sexual Medicine on the Amsterdam Cohort noted shifting trends in referrals, with increasing numbers of adolescent females presenting with later-onset dysphoria and comorbidities, differing from the early-onset, mentally healthy cohort in the original Dutch studies, rendering the protocol's applicability questionable;19
19 de Vries, A. L. C., et al., Trends in Gender Dysphoria Referrals: The Amsterdam Cohort, Journal of Sexual Medicine, 2023, https://academic.oup.com/jsm/article-abstract/20/3/345/6992345.
Whereas, further critiques, such as a 2023 article in City Journal, report that even in the Netherlands, there are growing second thoughts about the protocol, with debates over puberty blockers' risks and evidence gaps leading to calls for more cautious approaches;20
20 Sapir, L., Second Thoughts on the Dutch Protocol, City Journal, 2023, https://www.city-journal.org/article/second-thoughts-on-the-dutch-protocol.
Whereas, a 2023 analysis in Ethics and Public Policy Center outlined enduring deceptions in the Dutch protocol, including routine violation of its own eligibility criteria (e.g., applying it to cases with mental illness or non-binary identities despite exclusions), wrongful portrayal of puberty blockers as reversible and diagnostic, and ignoring evidence that most childhood gender dysphoria resolves without intervention;21
21 Leor Sapir, The Enduring Deceptions of the Dutch Protocol, Ethics and Public Policy Center, 2023, https://eppc.org/publication/enduring-deceptions-dutch-protocol/.
Whereas, earlier Dutch research from the 1990s, such as studies by Cohen-Kettenis and van Goozen, relied on even smaller samples (e.g., 22 participants) with similar flaws, including no controls and short-term follow-up, yet formed the basis for expanding the protocol without robust validation;22
22 Cohen-Kettenis, P. T., & van Goozen, S. H. M., Pubertal Delay as an Aid in Diagnosis and Treatment of Transsexual Adolescents, European Child & Adolescent Psychiatry, 1998, https://link.springer.com/article/10.1007/s007870050057.
Whereas, these cumulative criticisms demonstrate that WPATH SOC-8 and the Dutch protocol do not constitute rigorous, evidence-based standards, and continuing to fund gender transition services through public health mechanisms poses unacceptable risks to individuals, particularly minors, and burdens the healthcare system without proven benefits;
Whereas, it is in the public interest to exclude such services from publicly funded health coverage and to eliminate any associated benefits to prevent incentivizing unproven treatments;
Whereas, there has been an explosive increase in the incidence of individuals identifying as transgender, particularly among youth, with estimates rising from approximately 0.01% historically to over 3% of high school students in recent U.S. surveys, and dramatic surges in referrals to gender clinics worldwide, such as a reported increase in referrals to the Toronto gender identity clinic around the early 2000s;232425
23 Herman, J. L., et al., 2015 U.S. Transgender Survey, National Center for Transgender Equality, 2016, https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf.
24 Zucker, K. J., Epidemiology of Gender Dysphoria and Transgender Identity, Sexual Health, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149250/.
25 WPATH Files, Environmental Progress, 2024, https://environmentalprogress.org/wpath-files.
Whereas, this rise has been accompanied by a significant shift in the demographic cohort, from predominantly adult natal males with early-onset gender dysphoria to a majority of adolescent natal females presenting with rapid-onset or later-onset dysphoria, often with comorbidities such as anxiety, depression, or autism, with studies indicating that adolescents assigned female at birth now initiate transgender care 2.5 to 7.1 times more frequently than those assigned male at birth;26272829
26 Littman, L., Rapid-Onset Gender Dysphoria in Adolescents and Young Adults, PLoS ONE, 2018, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330.
27 Kaltiala-Heino, R., et al., Gender Dysphoria in Adolescence: Current Perspectives, Adolescent Health, Medicine and Therapeutics, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841333/.
28 Sapir, L., The Enduring Deceptions of the Dutch Protocol, Ethics and Public Policy Center, 2023, https://eppc.org/publication/enduring-deceptions-dutch-protocol/.
29 D’Angelo, R., Gender Dysphoria and Psychiatric Comorbidities, Journal of Child Psychology and Psychiatry, 2021, https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.13399.
Whereas, the presentation of gender dysphoria has shifted from persistent early childhood onset to sudden emergence during adolescence, often in the context of peer groups where multiple friends identify as transgender simultaneously, raising concerns about social influences;3031
30 Littman, L., Rapid-Onset Gender Dysphoria in Adolescents and Young Adults, PLoS ONE, 2018, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330.
31 Zucker, K. J., Epidemiology of Gender Dysphoria and Transgender Identity, Sexual Health, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149250/.
Whereas, this pattern parallels prior episodes of rapid increases in psychological conditions among adolescents, such as the spread of anorexia nervosa and bulimia in the late 20th century, where social contagion among high-anxiety, depressive girls led to epidemics of self-harm behaviors, as well as historical surges in multiple personality disorder diagnoses, suggesting that gender dysphoria may involve similar psychosocial dynamics rather than solely innate factors;32333435
32 Shrier, A., Irreversible Damage: The Transgender Craze Seducing Our Daughters, Regnery Publishing, 2020, https://www.regnery.com/9781684512287/irreversible-damage/.
33 Watters, E., Crazy Like Us: The Globalization of the American Psyche, Free Press, 2010, https://www.simonandschuster.com/books/Crazy-Like-Us/Ethan-Watters/9781416587095.
34 Abbruzzese, E., et al., The Myth of Reliable Research in Pediatric Gender Medicine, Journal of Sex and Marital Therapy, 2023, https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2150346.
35 McHugh, P. R., Psychiatric Misadventures, American Scholar, 1992, https://theamericanscholar.org/psychiatric-misadventures/.
Whereas, gender dysphoria in children and adolescents often lacks persistence, with historical longitudinal studies reporting desistance rates of 61% to 98%, meaning the majority of affected youth reconcile with their sex by adulthood without medical intervention;36373839404142
36 Zucker, K. J., Epidemiology of Gender Dysphoria and Transgender Identity, Sexual Health, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149250/.
37 Drummond, K. D., et al., A Follow-Up Study of Girls with Gender Identity Disorder, Journal of the American Academy of Child & Adolescent Psychiatry, 2008, https://www.jaacap.org/article/S0890-8567(09)60183-7/fulltext.
38 Wallien, M. S. C., & Cohen-Kettenis, P. T., Psychosexual Outcome of Gender-Dysphoric Children, Journal of the American Academy of Child & Adolescent Psychiatry, 2008, https://www.jaacap.org/article/S0890-8567(09)60182-5/fulltext.
39 Steensma, T. D., et al., Desisting and Persisting Gender Dysphoria After Childhood, Archives of Sexual Behavior, 2013, https://link.springer.com/article/10.1007/s10508-012-9991-x.
40 Ristori, J., & Steensma, T. D., Gender Dysphoria in Childhood, International Review of Psychiatry, 2016, https://www.tandfonline.com/doi/abs/10.3109/09540261.2015.1115754.
41 Cantor, J., Supplemental Expert Report, Boe v. Marshall, 2024, https://www.documentcloud.org/documents/24737435-cantor-report.
42 Cass, H., Independent Review of Gender Identity Services for Children and Young People: Final Report, 2024, https://cass.independent-review.uk/final-report/.
Whereas, transgender and gender-dysphoric youth exhibit a high prevalence of psychiatric comorbidities, with over 70% having at least one co-occurring mental health condition such as anxiety, depression, autism spectrum disorders, attention deficit disorders, or trauma-related issues, which may underlie or interact with gender dysphoria and necessitate addressing prior to irreversible interventions;43444546474849
43 Shrier, A., Irreversible Damage: The Transgender Craze Seducing Our Daughters, Regnery Publishing, 2020, https://www.regnery.com/9781684512287/irreversible-damage/.
44 Abbruzzese, E., et al., The Myth of Reliable Research in Pediatric Gender Medicine, Journal of Sex and Marital Therapy, 2023, https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2150346.
45 Kaltiala-Heino, R., et al., Gender Dysphoria in Adolescence: Current Perspectives, Adolescent Health, Medicine and Therapeutics, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841333/.
46 Kozlowska, K., et al., Australian Children and Adolescents with Gender Dysphoria, Journal of Child and Family Studies, 2021, https://link.springer.com/article/10.1007/s10826-021-01941-3.
47 Littman, L., Rapid-Onset Gender Dysphoria in Adolescents and Young Adults, PLoS ONE, 2018, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330.
48 Zucker, K. J., Epidemiology of Gender Dysphoria and Transgender Identity, Sexual Health, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149250/.
49 D’Angelo, R., Gender Dysphoria and Psychiatric Comorbidities, Journal of Child Psychology and Psychiatry, 2021, https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.13399.
Whereas, multiple studies indicate that a substantial proportion of gender-dysphoric children, if not subjected to gender-affirming care and instead allowed to undergo natural puberty, are likely to identify as gay, lesbian, or bisexual in adulthood, with estimates suggesting homosexuality or bisexuality as the most common outcome, raising ethical concerns that the gender-affirming model may disproportionately affect pre-homosexual youth and inadvertently serve as a form of conversion therapy;5051525354
50 Cantor, J., Gender Dysphoria and Sexual Orientation, Archives of Sexual Behavior, 2020, https://link.springer.com/article/10.1007/s10508-020-01768-9.
51 Bailey, J. M., & Blanchard, R., Gender Dysphoria and Sexual Orientation in Adolescents, Archives of Sexual Behavior, 2017, https://link.springer.com/article/10.1007/s10508-017-1047-7.
52 Ristori, J., & Steensma, T. D., Gender Dysphoria in Childhood, International Review of Psychiatry, 2016, https://www.tandfonline.com/doi/abs/10.3109/09540261.2015.1115754.
53 Zucker, K. J., Epidemiology of Gender Dysphoria and Transgender Identity, Sexual Health, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6149250/.
54 Kaltiala-Heino, R., et al., Gender Dysphoria in Adolescence: Current Perspectives, Adolescent Health, Medicine and Therapeutics, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841333/.
Whereas, many drugs used for gender transition services, such as puberty blockers (e.g., GnRH agonists like leuprolide) and cross-sex hormones (e.g., testosterone and estrogen), are prescribed off-label for gender dysphoria, meaning they lack formal approval from regulatory bodies like the U.S. Food and Drug Administration (FDA) or the Israeli Ministry of Health for this specific use, having been originally approved for conditions such as precocious puberty, prostate cancer, or menopausal symptoms;5556
55 Society for Evidence-Based Gender Medicine, Off-Label Use of Puberty Blockers and Hormones, 2023, https://segm.org/off-label-use-gender-dysphoria.
56 Hembree, W. C., et al., Endocrine Treatment of Gender-Dysphoric/Transgender Persons, Journal of Clinical Endocrinology & Metabolism, 2017, https://academic.oup.com/jcem/article/102/11/3869/4157558.
Whereas, the off-label use of these drugs for gender dysphoria is supported by limited and low-quality evidence, with the Cass Review and other analyses noting that such use carries significant risks, including unknown long-term effects, particularly in adolescents, and raises ethical concerns due to the absence of robust clinical trials demonstrating safety and efficacy for this purpose;5758
57 Cass, H., Independent Review of Gender Identity Services for Children and Young People: Final Report, 2024, https://cass.independent-review.uk/final-report/.
58 Abbruzzese, E., et al., The Myth of Reliable Research in Pediatric Gender Medicine, Journal of Sex and Marital Therapy, 2023, https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2150346.
Whereas, puberty blockers and cross-sex hormones carry significant and often irreversible harms, including infertility, reduced bone density, impaired sexual function, and long-term effects on brain development, with evidence indicating that these interventions impede natural pubertal processes in ways that cannot be fully reversed;596061
59 Society for Evidence-Based Gender Medicine, Health Risks of Puberty Blockers, 2023, https://segm.org/health-risks-puberty-blockers.
60 Cass, H., Independent Review of Gender Identity Services for Children and Young People: Final Report, 2024, https://cass.independent-review.uk/final-report/.
61 WPATH Files, Environmental Progress, 2024, https://environmentalprogress.org/wpath-files.
Whereas, long-term use of cross-sex hormones increases risks of serious health issues such as blood clots, cardiovascular disease, stroke, and certain cancers, contributing to elevated mortality rates among those who undergo these treatments;6263
62 Dhejne, C., et al., Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery, PLoS ONE, 2011, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885.
63 Getahun, D., et al., Cross-Sex Hormones and Acute Cardiovascular Events, Annals of Internal Medicine, 2018, https://www.acpjournals.org/doi/10.7326/M17-2785.
Whereas, gender transition surgeries are associated with high rates of complications, including urinary tract stenosis, necrosis, infection, loss of erotic sensation, wound breakdown, chronic pain, and conditions like constipation or irritable bowel syndrome, many of which are irreversible and require ongoing medical intervention;646566
64 Falcone, M., et al., Complications in Gender-Affirming Surgery, Journal of Sexual Medicine, 2021, https://academic.oup.com/jsm/article/18/9/1475/6345532.
65 Sapir, L., The Enduring Deceptions of the Dutch Protocol, Ethics and Public Policy Center, 2023, https://eppc.org/publication/enduring-deceptions-dutch-protocol/.
66 de Vries, A. L. C., et al., Trends in Gender Dysphoria Referrals: The Amsterdam Cohort, Journal of Sexual Medicine, 2023, https://academic.oup.com/jsm/article-abstract/20/3/345/6992345.
Whereas, the overall magnitude of harm extends to heightened risks of psychiatric morbidity, suicidal behavior, substance misuse, and exposure to violence or abuse, with studies showing considerably higher mortality and mental health challenges post-transition;6768
67 Dhejne, C., et al., Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery, PLoS ONE, 2011, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885.
68 Wiepjes, C. M., et al., Mental Health Outcomes in Transgender Individuals, Lancet Psychiatry, 2020, https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30483-7/fulltext.
Whereas, the economic costs of gender transition treatments, including hormones and surgeries, can exceed $100,000 per individual over a lifetime, often not covered by insurance and imposing substantial burdens on healthcare systems and patients, without demonstrated long-term cost savings or health benefits to justify the expenditure;69
69 Shrier, A., Irreversible Damage: The Transgender Craze Seducing Our Daughters, Regnery Publishing, 2020, https://www.regnery.com/9781684512287/irreversible-damage/.
Whereas, the revelations from Boe v. Marshall and related disclosures indicate a severe breakdown in the chain of trust fundamental to medical practice, where political and ideological influences led to experimental procedures being presented as a validated regimen of care, resulting in a high likelihood that consent for these procedures was not properly informed due to the suppression of critical evidence and manipulation of guidelines, rendering gender-affirming care so compromised that it should not be available;70717273
70 Cantor, J., Supplemental Expert Report, Boe v. Marshall, 2024, https://www.documentcloud.org/documents/24737435-cantor-report.
71 The New York Times, Leaked Files Show Medical Group’s Influence on Gender Care Guidelines, 2024, https://www.nytimes.com/2024/06/25/health/transgender-wpath-guidelines.html.
72 Sapir, L., WPATH’s Suppression of Evidence, City Journal, 2024, https://www.city-journal.org/article/wpaths-suppression-of-evidence.
73 The Atlantic, Political Pressure on WPATH Guidelines, 2024, https://www.theatlantic.com/health/archive/2024/06/wpath-political-pressure/678921/.
In this Law:
“Gender transition services” means any medical, pharmaceutical, or surgical interventions, including but not limited to puberty-suppressing drugs, cross-sex hormone therapy, mastectomies, hysterectomies, phalloplasties, vaginoplasties, or other procedures, that are intended to alter primary or secondary sex characteristics for the purpose of aligning an individual's physical appearance with their gender identity, excluding treatments for congenital conditions such as intersex disorders or medically necessary reconstructions unrelated to gender dysphoria.
“Gender-affirming care” means a model of care that encompasses a range of social, psychological, behavioral, and medical interventions designed to support and affirm an individual's gender identity when it differs from their sex, including social transition, hormone therapy, and surgical procedures, often without requiring extensive psychological evaluation or addressing underlying comorbidities first;74757677
74 Society for Evidence-Based Gender Medicine, Off-Label Use of Puberty Blockers and Hormones, 2023, https://segm.org/off-label-use-gender-dysphoria.
75 Falcone, M., et al., Complications in Gender-Affirming Surgery, Journal of Sexual Medicine, 2021, https://academic.oup.com/jsm/article/18/9/1475/6345532.
76 Biggs, M., The Dutch Protocol for Juvenile Transsexuals: Origins and Evidence, Journal of Sex Research, 2022, https://www.tandfonline.com/doi/full/10.1080/00224499.2022.2043951.
77 Sapir, L., The Enduring Deceptions of the Dutch Protocol, Ethics and Public Policy Center, 2023, https://eppc.org/publication/enduring-deceptions-dutch-protocol/.
“Gender identity” means an individual's internal sense of their own gender, whether male, female, or something else, which may or may not correspond to their sex.
“Sex” means the biological and genetic makeup of an individual, determined by their chromosomal composition (typically XX for female and XY for male) as established at conception or, in cases of ambiguity due to disorders of sexual development, confirmed through genetic testing.
“Health services basket” means the basket of health services as defined under Section 7 of the National Health Insurance Law, 5754-1994.
“Health funds” means the health maintenance organizations (Kupot Holim) obligated to provide services under the National Health Insurance Law, 5754-1994.
“Benefits” means any social security payments, disability allowances, tax credits, employment protections, or other state-provided financial or non-financial entitlements under laws such as the National Insurance Law, 5755-1995, or related regulations.
This Law shall come into force 60 days after its publication in the Reshumot.
Whereas, the provision of gender transition services, including puberty blockers, cross-sex hormones, and surgeries intended to alter sex characteristics, has been guided internationally by standards promulgated by the World Professional Association for Transgender Health Standards of Care version 8 (WPATH SOC-8), which have faced substantial criticism for lacking rigor and overstating the strength of available evidence;
Whereas, the Cass Review, commissioned by the National Health Service in England and published in 2024, concluded that the evidence base for gender-affirming medical interventions in youth is of poor quality, with WPATH SOC-8 criticized for overstating the reliability of studies and failing to adhere to evidence-based standards, leading to recommendations that do not sufficiently account for risks such as infertility, bone density loss, and long-term psychological outcomes;
Whereas, leaked internal communications from WPATH members, as reported in 2024, revealed concerns among professionals about the lack of informed consent, suppression of unfavorable research, and ethical issues in applying SOC-8, including instances where members acknowledged that patients, particularly minors, may not fully understand the lifelong implications of treatments;
Whereas, the U.S. Department of Health and Human Services report on gender dysphoria, published in 2025, highlighted WPATH's manipulation of evidence reviews, noting that WPATH leadership was unprepared for external scrutiny of their guidelines and had influenced processes to downplay risks, such as by pressuring researchers to alter findings on puberty blockers;
Whereas, analyses from organizations like the Society for Evidence-Based Gender Medicine (SEGM) and critiques in legal contexts, such as Florida court documents from 2023, have pointed out that WPATH SOC-8 partially incorporates but inadequately applies clinical practice guideline development standards, resulting in recommendations based on low-quality evidence and expert opinion rather than rigorous trials;
Whereas, an article by Sex Matters in 2022 detailed how WPATH SOC-8 abandons evidence-based safeguards, such as mandatory mental health assessments, and promotes ideological language over medical accuracy, while ignoring comorbidities like autism and failing to set minimum age limits for irreversible interventions, raising serious ethical and child safeguarding concerns;
Whereas, unsealed documents from the U.S. federal lawsuit Boe v. Marshall in 2024 revealed that WPATH suppressed systematic evidence reviews commissioned from Johns Hopkins University, which concluded there was insufficient evidence supporting the benefits of gender-affirming care, in order to maintain support for their preferred treatment approaches;
Whereas, the same documents disclosed political manipulation of SOC-8, including pressure from U.S. Assistant Secretary for Health Rachel Levine to eliminate minimum age recommendations for hormonal and surgical interventions, prioritizing avoidance of political backlash over scientific evidence;
Whereas, the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) inventory of evidence, published in 2022, concluded that the scientific evidence for puberty blockers and cross-sex hormones in treating gender dysphoria in children and adolescents is insufficient, with studies suffering from high risk of bias, small sample sizes, and lack of long-term follow-up, leading Sweden to restrict such treatments outside of clinical trials;
Whereas, the Finnish Council for Choices in Health Care (COHERE) recommendations from 2020 emphasized that medical interventions for gender dysphoria in minors should not be routinely provided, prioritizing psychosocial support and psychotherapy due to the weak evidence base and potential for natural resolution of dysphoria, with hormonal treatments reserved only for exceptional cases after extensive evaluation;
Whereas, criticisms of the research underpinning WPATH SOC-8 extend back to the Dutch protocol, which originated from studies in the 1990s and early 2000s at the Amsterdam University Medical Center and has been foundational to gender-affirming care models;
Whereas, a 2023 analysis by SEGM identified profound methodological flaws in the Dutch studies, including small sample sizes (e.g., final cohorts of 55-70 participants), lack of control groups, selective reporting of only positive outcomes while excluding dropouts and adverse events (such as one death and cases of severe morbidity like diabetes), confounding effects from concurrent psychotherapy, misuse of assessment scales leading to erroneous claims of gender dysphoria resolution, and failure to evaluate physical risks like sterility and bone health impacts;
Whereas, sociologist Michael Biggs' 2022 review of the Dutch protocol highlighted that a British replication attempt at the Tavistock clinic failed to show improvements in gender dysphoria or psychological functioning, and critiqued the original studies for lacking randomization, having high loss to follow-up, and preconceived biases favoring medical interventions over natural maturation or therapy;
Whereas, a 2023 paper in the Journal of Sexual Medicine on the Amsterdam Cohort noted shifting trends in referrals, with increasing numbers of adolescent females presenting with later-onset dysphoria and comorbidities, differing from the early-onset, mentally healthy cohort in the original Dutch studies, rendering the protocol's applicability questionable;
Whereas, further critiques, such as a 2023 article in City Journal, report that even in the Netherlands, there are growing second thoughts about the protocol, with debates over puberty blockers' risks and evidence gaps leading to calls for more cautious approaches;
Whereas, a 2023 analysis in Ethics and Public Policy Center outlined enduring deceptions in the Dutch protocol, including routine violation of its own eligibility criteria (e.g., applying it to cases with mental illness or non-binary identities despite exclusions), wrongful portrayal of puberty blockers as reversible and diagnostic, and ignoring evidence that most childhood gender dysphoria resolves without intervention;
Whereas, earlier Dutch research from the 1990s, such as studies by Cohen-Kettenis and van Goozen, relied on even smaller samples (e.g., 22 participants) with similar flaws, including no controls and short-term follow-up, yet formed the basis for expanding the protocol without robust validation;
Whereas, these cumulative criticisms demonstrate that WPATH SOC-8 and the Dutch protocol do not constitute rigorous, evidence-based standards, and continuing to fund gender transition services through public health mechanisms poses unacceptable risks to individuals, particularly minors, and burdens the healthcare system without proven benefits;
Whereas, it is in the public interest to exclude such services from publicly funded health coverage and to eliminate any associated benefits to prevent incentivizing unproven treatments;
Whereas, there has been an explosive increase in the incidence of individuals identifying as transgender, particularly among youth, with estimates rising from approximately 0.01% historically to over 3% of high school students in recent U.S. surveys, and dramatic surges in referrals to gender clinics worldwide, such as a reported increase in referrals to the Toronto gender identity clinic around the early 2000s;
Whereas, this rise has been accompanied by a significant shift in the demographic cohort, from predominantly adult natal males with early-onset gender dysphoria to a majority of adolescent natal females presenting with rapid-onset or later-onset dysphoria, often with comorbidities such as anxiety, depression, or autism, with studies indicating that adolescents assigned female at birth now initiate transgender care 2.5 to 7.1 times more frequently than those assigned male at birth;
Whereas, the presentation of gender dysphoria has shifted from persistent early childhood onset to sudden emergence during adolescence, often in the context of peer groups where multiple friends identify as transgender simultaneously, raising concerns about social influences;
Whereas, this pattern parallels prior episodes of rapid increases in psychological conditions among adolescents, such as the spread of anorexia nervosa and bulimia in the late 20th century, where social contagion among high-anxiety, depressive girls led to epidemics of self-harm behaviors, as well as historical surges in multiple personality disorder diagnoses, suggesting that gender dysphoria may involve similar psychosocial dynamics rather than solely innate factors;
Whereas, gender dysphoria in children and adolescents often lacks persistence, with historical longitudinal studies reporting desistance rates of 61% to 98%, meaning the majority of affected youth reconcile with their sex by adulthood without medical intervention;
Whereas, transgender and gender-dysphoric youth exhibit a high prevalence of psychiatric comorbidities, with over 70% having at least one co-occurring mental health condition such as anxiety, depression, autism spectrum disorders, attention deficit disorders, or trauma-related issues, which may underlie or interact with gender dysphoria and necessitate addressing prior to irreversible interventions;
Whereas, multiple studies indicate that a substantial proportion of gender-dysphoric children, if not subjected to gender-affirming care and instead allowed to undergo natural puberty, are likely to identify as gay, lesbian, or bisexual in adulthood, with estimates suggesting homosexuality or bisexuality as the most common outcome, raising ethical concerns that the gender-affirming model may disproportionately affect pre-homosexual youth and inadvertently serve as a form of conversion therapy;
Whereas, many drugs used for gender transition services, such as puberty blockers (e.g., GnRH agonists like leuprolide) and cross-sex hormones (e.g., testosterone and estrogen), are prescribed off-label for gender dysphoria, meaning they lack formal approval from regulatory bodies like the U.S. Food and Drug Administration (FDA) or the Israeli Ministry of Health for this specific use, having been originally approved for conditions such as precocious puberty, prostate cancer, or menopausal symptoms;
Whereas, the off-label use of these drugs for gender dysphoria is supported by limited and low-quality evidence, with the Cass Review and other analyses noting that such use carries significant risks, including unknown long-term effects, particularly in adolescents, and raises ethical concerns due to the absence of robust clinical trials demonstrating safety and efficacy for this purpose;
Whereas, puberty blockers and cross-sex hormones carry significant and often irreversible harms, including infertility, reduced bone density, impaired sexual function, and long-term effects on brain development, with evidence indicating that these interventions impede natural pubertal processes in ways that cannot be fully reversed;
Whereas, long-term use of cross-sex hormones increases risks of serious health issues such as blood clots, cardiovascular disease, stroke, and certain cancers, contributing to elevated mortality rates among those who undergo these treatments;
Whereas, gender transition surgeries are associated with high rates of complications, including urinary tract stenosis, necrosis, infection, loss of erotic sensation, wound breakdown, chronic pain, and conditions like constipation or irritable bowel syndrome, many of which are irreversible and require ongoing medical intervention;
Whereas, the overall magnitude of harm extends to heightened risks of psychiatric morbidity, suicidal behavior, substance misuse, and exposure to violence or abuse, with studies showing considerably higher mortality and mental health challenges post-transition;
Whereas, the economic costs of gender transition treatments, including hormones and surgeries, can exceed $100,000 per individual over a lifetime, often not covered by insurance and imposing substantial burdens on healthcare systems and patients, without demonstrated long-term cost savings or health benefits to justify the expenditure;
Whereas, the revelations from Boe v. Marshall and related disclosures indicate a severe breakdown in the chain of trust fundamental to medical practice, where political and ideological influences led to experimental procedures being presented as a validated regimen of care, resulting in a high likelihood that consent for these procedures was not properly informed due to the suppression of critical evidence and manipulation of guidelines, rendering gender-affirming care so compromised that it should not be available;
In this Law:
“Gender transition services” means any medical, pharmaceutical, or surgical interventions, including but not limited to puberty-suppressing drugs, cross-sex hormone therapy, mastectomies, hysterectomies, phalloplasties, vaginoplasties, or other procedures, that are intended to alter primary or secondary sex characteristics for the purpose of aligning an individual's physical appearance with their gender identity, excluding treatments for congenital conditions such as intersex disorders or medically necessary reconstructions unrelated to gender dysphoria.
“Gender-affirming care” means a model of care that encompasses a range of social, psychological, behavioral, and medical interventions designed to support and affirm an individual's gender identity when it differs from their sex, including social transition, hormone therapy, and surgical procedures, often without requiring extensive psychological evaluation or addressing underlying comorbidities first;
“Gender identity” means an individual's internal sense of their own gender, whether male, female, or something else, which may or may not correspond to their sex.
“Sex” means the biological and genetic makeup of an individual, determined by their chromosomal composition (typically XX for female and XY for male) as established at conception or, in cases of ambiguity due to disorders of sexual development, confirmed through genetic testing.
“Health services basket” means the basket of health services as defined under Section 7 of the National Health Insurance Law, 5754-1994.
“Health funds” means the health maintenance organizations (Kupot Holim) obligated to provide services under the National Health Insurance Law, 5754-1994.
“Benefits” means any social security payments, disability allowances, tax credits, employment protections, or other state-provided financial or non-financial entitlements under laws such as the National Insurance Law, 5755-1995, or related regulations.
This Law shall come into force 60 days after its publication in the Reshumot.
End the Butchery Now
ברית LGB הפכה לבינלאומית. המטרה שלהם:
לספק קול גלובלי לייצג את הדעות של ולדגול למען אנשי LGB ברמה גלובלית, כולל בפני סוכנויות האו"ם ומוסדות רב-לאומיים.
“אנו דוגלים בזכותם של מבוגרים וצעירים להתבגר, להתפתח ולחקור את מיניותם ואישיותם ללא אידיאולוגיית זהות מגדרית. ילדים צריכים להיות מוגנים מטיפולים רפואיים של מעבר מגדרי. אנו נלחמים במידע שגוי מזיק ובדיסאינפורמציה על אידיאולוגיית זהות מגדרית שמכוונת במיוחד ללסביות, גברים הומוסקסואלים וביסקסואלים.”
LGB International הוא הפדרציה של ארגונים לאומיים של לסביות, גברים הומוסקסואלים וביסקסואלים. מאז שברית LGB החלה בבריטניה בשנת 2019, קבוצות החלו במגוון מדינות, בונות מחדש תנועה עבור אנשי LGB שאינם מנויים על אידיאולוגיית מגדר.
בברכה
David R. Herz
עצרו את הטבח עכשיו