Laura Edwards-Lieper

And often, she said, the kid was also talking to a therapist while they were going through this process. But Jo didn't think it had to be mandatory or for a set period of time.

And often, she said, the kid was also talking to a therapist while they were going through this process. But Jo didn't think it had to be mandatory or for a set period of time.

The way Joe was thinking about assessment reflected a broader push that was underway against so-called gatekeeping in trans medicine for adults.

The way Joe was thinking about assessment reflected a broader push that was underway against so-called gatekeeping in trans medicine for adults.

For years, patients and advocates had been challenging the prominent role of psychotherapy and were finally getting doctors to ease some of the requirements for treatment, including the need for patients to get a letter of approval from a therapist before starting hormones.

For years, patients and advocates had been challenging the prominent role of psychotherapy and were finally getting doctors to ease some of the requirements for treatment, including the need for patients to get a letter of approval from a therapist before starting hormones.

They argued that these requirements showed an ongoing mistrust of trans people and of patients' own understanding of who they were and what they needed.

They argued that these requirements showed an ongoing mistrust of trans people and of patients' own understanding of who they were and what they needed.

Joe was among a growing group of providers who were making a similar case for kids, that the strict requirements of the Dutch protocol were outdated and perpetuated that mistrust, and that children should be believed when they say what their gender is.

Joe was among a growing group of providers who were making a similar case for kids, that the strict requirements of the Dutch protocol were outdated and perpetuated that mistrust, and that children should be believed when they say what their gender is.

Joe began to talk publicly about her approach.

Joe began to talk publicly about her approach.

And she also began speaking about something else.

And she also began speaking about something else.

She started to talk about this care in life or death terms.

She started to talk about this care in life or death terms.

Joe wasn't alone in this either. As visibility around trans kids was growing in the US, there was also growing awareness that, like trans adults, this was a group at much higher risk of suicidal thoughts and behaviors than the general population. One frequently cited study from the time found that nearly half of the young trans people surveyed had seriously considered dying by suicide.

Joe wasn't alone in this either. As visibility around trans kids was growing in the US, there was also growing awareness that, like trans adults, this was a group at much higher risk of suicidal thoughts and behaviors than the general population. One frequently cited study from the time found that nearly half of the young trans people surveyed had seriously considered dying by suicide.

About a quarter of them said they had actually tried to.

About a quarter of them said they had actually tried to.