Pass the Chloe Cole Act!

A sign indicating male and female facilities at Sydney Airport in Australia on Oct. 12, 2025. Susan Mortimer/The Epoch Times

The Chloe Cole Act: Safeguarding Children from Irreversible Harm

Approximately 6-minute read

The claim that children can be safely “transitioned” from male to female—or vice versa—through puberty blockers, cross-sex hormones, and surgeries is extraordinary. It demands extraordinary evidence. Yet the evidence, drawn from rigorous reviews and recent high-quality studies, reveals an extraordinary lack of support for so-called “gender-affirming care.” Instead, it points to real and lasting harm. This is why the Chloe Cole Act (H.R. 5483), introduced in the 119th Congress by Rep. Robert F. Onder (R-MO), deserves swift passage.

Named after detransitioner Chloe Cole—who underwent puberty blockers at 13, testosterone at 13, and a double mastectomy at 15, only to regret it and begin detransitioning at 16—the bill prohibits health care professionals, hospitals, and clinics from performing chemical or surgical interventions intended to alter a minor’s body to match a gender identity incongruent with biological sex. It defines these as “chemical or surgical mutilation” and creates a private right of action, allowing victims or their parents to sue for damages with a statute of limitations extending 25 years after the child’s 18th birthday (or four years after detransition costs). Exceptions are narrowly drawn for verifiable disorders of sexual development. The companion Senate bill (S. 2907), led by Sen. Marsha Blackburn, mirrors this approach.

Cole’s story is heartbreaking but not unique. She has testified that clinicians failed to explore her underlying mental health issues and rushed her into irreversible procedures. Her case exemplifies the rushed “affirmation” model now facing global scrutiny. Importantly, Chloe Cole’s malpractice lawsuit against Kaiser Permanente is now moving forward, with her trial scheduled for April 5, 2027. This development underscores the growing legal accountability for providers who performed these interventions on minors and strengthens the case for federal legislation like the Chloe Cole Act to prevent future harm.

The Evidence Against “Gender-Affirming Care” for Minors

Multiple independent analyses have dismantled the weak foundation of pediatric gender interventions. The United Kingdom’s Cass Review (2024), a comprehensive independent assessment commissioned by NHS England, concluded that the evidence base for puberty blockers and cross-sex hormones in youth is “remarkably weak.” It found no reliable proof that these treatments improve mental health or resolve gender dysphoria long-term. Instead, the review highlighted risks including infertility, sexual dysfunction, impaired bone density, and unknown effects on brain development. As a result, the NHS restricted puberty blockers to clinical trials only.

Similarly, the U.S. Department of Health and Human Services’ 2025 report, Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, employed rigorous evidence-based methodology and reached stark conclusions: the quality of evidence for puberty blockers, cross-sex hormones, and surgeries is “very low.” Benefits for mental health or dysphoria relief cannot be substantiated, while harms—including infertility, cardiovascular risks, psychiatric worsening, and surgical complications—are well-documented and often undertracked. The report emphasizes an unfavorable risk-benefit profile and recommends prioritizing psychotherapy and exploratory approaches over medicalization.

NO one is born in the wrong body!

Now comes even stronger confirmation from Finland. The study Psychiatric Morbidity Among Adolescents and Young Adults Who Contacted Specialised Gender Identity Services in Finland in 1996–2019: A Register Study, authored by Sami-Matti Ruuska, Katinka Tuisku, Timo Holttinen, and Riittakerttu Kaltiala, was published April 4, 2026, in the peer-reviewed journal Acta Paediatrica (DOI: 10.1111/apa.70533). Researchers examined nearly 2,100 adolescents and young adults who sought care for gender dysphoria and compared them to age- and gender-matched controls.

The results are alarming. The gender-dysphoric cohort already suffered significantly higher rates of psychiatric problems. After “care” at gender identity clinics, mental health worsened. For those transitioning male-to-female, psychiatric issues (depression, anxiety, etc.) surged from 10% pre-treatment to 61% post-treatment. For female-to-male patients, the rise was from 22% to 55%. Far from alleviating distress, the interventions correlated with steeper declines in well-being.

Commentary from Pediatrician J. Edward Les

-This commentary first appeared in Epoch Times  4/20/2026

Pediatrician J. Edward Les, a senior fellow at the Aristotle Foundation for Public Policy practicing in Calgary, offers a clear-eyed assessment of these findings and their implications:

“The claim that it’s possible to transition from male to female (and vice versa) is an extraordinary statement. So, it’s reasonable to demand extraordinary evidence, before supporting the practice of ‘gender-affirming care,’ which involves treatment with puberty blockers, cross-gender hormones (estrogen or testosterone), and in some cases surgery to remove breasts or modify genitalia.

“And what do we find? An extraordinary lack of evidence in its favour.

“Multiple comprehensive analyses including the United Kingdom’s ‘Cass Review’ and the U.S. Department of Health and Human Services’ ‘Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices’ have exposed the thin evidence underpinning this therapeutic model, and have strongly suggested that rather than providing benefit, these practices cause real and lasting harm.

“And now we have another large high-quality study recently published by Finnish researchers in the peer-reviewed journal Acta Paediatrica, which casts grave doubt on the efficacy of ‘gender-affirming care.’

“The Finns reviewed the psychiatric well-being of almost 2,100 adolescents and young adults who sought therapy for gender dysphoria between 1996 and 2019 and compared them to age-and-gender-matched controls.

“The findings are startling. Not only did the gender dysphoria cohort have significantly more mental health problems, but their mental health worsened after receiving ‘care’ at gender identity clinics. For ‘male to female’ patients, mental health problems (such as depression and anxiety) rose from 10 percent before gender reassignment to 61 percent afterwards; for ‘female to male’ patients, the increase was from 22 percent to 55 percent.

“We’ve long been fed the dogma by transgender advocates that ‘affirming’ troubled young people in their cross-gender identities is the only responsible thing to do—that it’s essential to their well-being. In many cases, parents of gender-confused youth have been scared into transitioning their children by clinicians mouthing a version of ‘Would you rather have a dead daughter or a live son?’

“But the findings of the Finnish researchers pour ice-cold water on the notion that ‘gender-affirming care’ results in improved psychiatric well-being. Turns out, just the opposite is true.

“It’s worth noting that one of the authors of the Finnish study is Dr. Riittakerttu Kaltiala, a psychiatrist at Tampere University, who founded one of Finland’s two pediatric gender clinics in 2011. As she documented her observations over the years, Dr. Kaltiala grew increasingly concerned about the harms inflicted by the ‘gender affirmation’ model and she was instrumental in significantly restricting that model’s suggested medical interventions for minors; Finland now instead prioritizes psychological support over puberty blockers and cross-sex hormones.

“Dr. Kaltiala expressed her battle-tested viewpoint in a much-read piece in The Free Press titled ‘Gender-Affirming Care Is Dangerous. I Know Because I Helped Pioneer It.’

“Various other European jurisdictions have similarly tapped the brakes. On this side of the pond, caution is taking root in the United States. The American Society of Plastic Surgeons, for instance, recently issued a statement (subsequently endorsed by the American Medical Association), which recommends that surgeons delay gender-related breast, genital, and facial surgery until patients are at least 19 years old.

“In Canada, however, not much has changed (apart from in Alberta where the government has taken flak for restricting medical and surgical interventions in gender-confused youth). The gender-affirmation model remains the standard of care for kids in this country, with the full-throated endorsement of the Canadian Medical Association, the Canadian Pediatric Society, and provincial medical associations. In light of all we now know about the dangers of this approach, that too is truly extraordinary.

“One can choose, as Canadian doctors and medical leaders have inexplicably done, to ignore the facts of human biology and deny the binary nature of our species. But as Aldous Huxley once noted, ‘Facts do not cease to exist because they are ignored.’

“And we ignore those facts to the detriment of our children.”

Dr. Les’s analysis underscores a growing international consensus: the “affirmation” model is failing our kids. Finland, Sweden, Norway, and the UK have all shifted toward psychotherapy-first approaches. Even the American Society of Plastic Surgeons now urges delaying surgeries until adulthood. The United States cannot afford to lag behind.

Time for Congress to Act

The Chloe Cole Act is not about denying care to children with genuine medical conditions. It carves out clear exceptions for disorders of sexual development and focuses solely on non-evidence-based interventions for gender dysphoria. By banning these procedures for minors and empowering victims with legal recourse, the bill protects vulnerable youth from experimentation with life-altering drugs and surgeries whose benefits remain unproven and whose harms are increasingly documented.

Chloe Cole and thousands like her deserve justice. More importantly, today’s gender-confused children deserve protection from a medical fad that prioritizes ideology over science. Congress must pass the Chloe Cole Act without delay. Our children’s futures—literally their bodies and minds—depend on it.

NO one is born in the wrong body!