Ill treatment

When David Bergner’s prepubescent son began wearing dresses, identifying as a girl, and struggling with anxiety, he decided to get help. For Bergner, “help” came from the Ann & Robert H. Lurie Children’s Hospital of Chicago, where his child, now 9, received gender identity counseling. The hospital has opened the first “clinic” in the Midwest for preteens who question their gender. Led by Dr. Rob Garofalo of the hospital’s Center for Gender, Sexuality, and HIV Prevention, the new clinic hasn’t officially launched, but has already treated about 25 patients. Bergner told Chicago radio station WBEZ in February the gender identity clinic was an “excellent thing.”

But it’s a troubling trend: The Lurie program is one of a handful of children’s gender identity clinics to spring up in the United States over the past six years. These clinics provide psychological counseling intended to help children choose whatever gender they feel is best, and offer hormonal treatments to delay the onset of puberty.

The first such clinic in the Western Hemisphere opened at Boston Children’s Hospital in 2007. Now, Seattle Children’s Hospital, Children’s Hospital Los Angeles, and Benioff Children’s Hospital in San Francisco all provide hormonal treatment for kids questioning their gender. Doctors at other hospitals may provide hormonal treatment but not advertise it openly.

On its website, the Gender Management Service Clinic at Boston Children’s Hospital says its doctors “help children cope with the disconnect they may feel between the body and gender they were born with .... Therefore, we try to help them develop a body that is consistent with their identity.”

Some patients about to reach the age of puberty (around 11 or 12) aren’t yet sure what gender they want to be. To give them extra time to make up their minds, the clinics offer drug implants or shots costing $1,000 a month that delay the bodily changes associated with manhood or womanhood. In girls, the treatment blocks naturally produced estrogen, preventing the development of breasts and widened hips. In boys, the treatment blocks testosterone that normally produces facial hair and a protruding Adam’s apple.

If a child ultimately decides to identify as a gender other than what his or her chromosomes dictate, clinics may provide estrogen or testosterone injections to produce the desired bodily characteristics. The effects of the shots, such as breast growth, are permanent. Some clinics even offer “sex-change” surgery when the child is older.

Children’s feelings aren’t a reliable guide for deciding on life-altering treatments, though: Studies show many kids who question their gender stop doing so after puberty.

Miscounting calories

As U.S. federal regulators prepare to force restaurants to display menu food calories, some scientists are challenging the standard method of calculating them. Under a century-old system, calories are tallied based on the number of grams of fat, protein, or carbohydrates in food.

At February’s annual meeting of the American Association for the Advancement of Science, researchers said that approach is simplistic: A variety of factors—microbial activity in the gut, whether foods are raw or cooked, whether foods (like nuts) are completely chewed—together influence how many calories the body absorbs. Meaning weight watching just got more complicated. —D.J.D.