Medical Revolt and the Abandonment of the Dutch Protocol: Comparative Views on the Provision of Gender-affirming Care to Children

expression" 9 -when his teachers and classmates voted him prom king. 10liver Jones' experience with gender dysphoria is not entirely unique.Nor is it unusual that a young person would seek medical treatment after a diagnosis of gender dysphoria.Indeed, medical protocols, like those based on the work of Dutch researchers and referred to as the Dutch Protocol or the Dutch Approach, exist and are widely accepted procedures for the treatment of gender dysphoria in children and adolescents.Recently, however, the Dutch Protocol has been called into question by health care services in several European countries. 11urope is not alone.Transgender individuals have been in the United States since before its inception. 12In the 1990's, the transgender rights movement began to coalesce into a social force. 13But even as trans rights began to increase, the U.S. government sought to exclude trans people from receiving health care. 14 The Americans with Disabilities Act, for example, included a set of exclusions, among them transgender people. 15 This exclusion was the result of animosity from two senators who viewed sexual behavior disorder to be unworthy of legal protection. 16Today, attempts to bar transgender people from access to health care still exist in other forms.In particular, a number of conservative states have introduced, considered, or passed legislation restricting or denying genderaffirming care to adolescents and children. 17efore delving into the content of this article, a note on terminology.For purposes of this article, I use "transgender" to mean "people whose gender identity and/or expression is different from cultural expectations based on the sex they were assigned at birth." 18 This is as opposed to someone who is "cisgender"