The Gender Dysphoria Support Tool

A Sample Letter for Parents to Use

Earlier this year Genspect released The Gender Dysphoria Support Tool which includes The Family and Friends Survey and The Parental Survey. As highlighted in a prior PITT piece, the surveys were developed as a means to “invert the process and shift the burden of proof” regarding the efficacy of “gender affirming care” onto medical and mental health providers. Once completed, the surveys can be sent to individuals and organization such as health care providers, schools, hospitals, insurances companies, etc. to give them notice of parental concerns, and even to serve as evidence in potential lawsuits. The developer of this tool hopes it can also be a benefit to parents of older children who feel they have very little influence over decisions their child makes. The developer says, “I notice many parents just give in at the end, desperate, not knowing what to do anymore.” But he believes that parents can be influential by putting pressure on medical providers and insurance companies, especially now as lawmakers are formally accusing the AAP of violating consumer protection statues over claims that “gender affirming care” is safe and reversible.

Following is an example of a letter to an insurance company. Perhaps there are PITT parents who will want to send something similar to their own doctors, mental health providers, hospitals, or insurance companies.

Dear Sir/Madam,

I am writing to you as a health insurer because I have serious concerns about the diagnostic practices and reimbursement claims of gender clinics. There are strong indications that these clinics systematically fail to follow a rigorous diagnostic process. This raises concerns about potentially unjustified claims and, in some cases, possible misuse of healthcare funds.

Below, I present a case from the Netherlands. While the healthcare system may differ from country to country, this case highlights fundamental questions about how gender-related diagnoses are made, the role of parental observations, and whether these practices align with ethical and legal standards.

Case: Scientifically Substantiated Parental Observations Were Ignored

Attached to this letter, you will find a scientifically designed questionnaire that parents used to objectively assess whether their child was experiencing gender dysphoria. Eight direct family members completed this questionnaire yet none of them recognized any signs of gender dysphoria or transgender identity. Additionally, the family’s private doctor stated that the child’s self-reported identity was not reflected in their behavior or emotional expressions.

This information was provided to the treating gender clinic at Radboud Hospital. The clinical psychologist responsible for the diagnosis confirmed that the questionnaire was well-constructed and methodologically sound. This statement was recorded in an audio file, which has been handed over to a lawyer as evidence. However, despite acknowledging the validity of the questionnaire, the clinic ignored the parents’ concerns entirely. The questions raised in the questionnaire remained unanswered.

Months later, the parents learned from their son that the clinic had nevertheless issued a positive diagnosis. This decision directly contradicted the findings of the family assessment and the general practitioner’s observations. When asked about their reasoning, the clinical psychologist reportedly told the son: “We cannot truly diagnose because we lack the tools to diagnose. We can only follow the patient’s wishes.”

This raises serious concerns. The clinic itself admits that it lacks objective diagnostic tools, yet it disregarded an independently validated diagnostic instrument (The Family Questionnaire). Despite acknowledging this diagnostic gap, the clinic still issued a diagnostic code to justify treatment coverage. This raises significant medical and ethical questions:

1 - If a clinic cannot properly diagnose, on what basis can it assign a diagnostic code?

2 - How can a self-diagnosis be considered valid when counter-evidence exists from multiple family members and a medical professional?

A Critical Question for Gender Clinics

This case highlights an important issue: Why do clinics invite parents to provide their perspective if their input is ultimately ignored? Given these concerns, I urge you, as an insurer, to ask the gender clinics you work with the following key question:

3 - “Can you provide an example of a patient case where the family indicated that the patient’s self-assessment was incorrect and suspected alternative causes (such as autism, internalized self-hatred, or shame over homosexuality), and where the specialist adjusted the diagnosis based on the family’s assessment?”

I suspect that no such case exists. If this assumption is correct, it suggests that gender clinics systematically use diagnostic codes without critically evaluating all available information. It also implies that families are misled into believing their input matters when, in reality, it is disregarded.

Ensuring Medical and Ethical Integrity in Diagnoses

Bodily autonomy is a fundamental right, meaning individuals should have control over their own medical decisions. However, this right does not extend to receiving a medical diagnosis based solely on personal belief or preference. A medical diagnosis must be based on objective criteria and established medical evidence.

When a diagnosis is made without a factual foundation and is instead influenced by non-medical considerations, it can lead to misinformed medical decisions and inappropriate treatment. While families should not dictate medical diagnoses, these diagnoses should also not be made in isolation from broader medical and social contexts. This raises critical questions:

4 - On what objective basis did the clinical psychologist conclude that the family had a false perception of the situation?

5 - Are these findings more medically reliable than the general practitioner’s assessment and the results of a structured family evaluation?

Lack of Transparency and Risk of Unjustified Claims

As a health insurer, you do not have full visibility into the diagnostic process within a clinic. You only receive reimbursement claims for cases where a positive diagnosis has been issued since negative diagnoses do not require financial coverage. If clinics systematically issue positive diagnoses, this creates a risk of unjustified claims going unnoticed.

This raises the following concerns:

6- How do you ensure that gender clinics follow objective medical criteria rather than a policy-driven or commercial preference for affirmative diagnoses?

7 - What measures do you take to prevent insurance fraud and ensure that all reimbursed treatments are medically necessary and properly justified?

If a clinic has acted non-transparently, issued an inaccurate diagnosis, or used an unjustified diagnostic code, this could constitute misrepresentation or fraud. In such cases, a health insurer has the right to reclaim improper reimbursements, as these claims would not be based on valid medical grounds. This aligns with legal and contractual obligations between insurers and healthcare providers.

I urge you to thoroughly investigate these concerns and take appropriate action. Given the potential scale of this issue and its impact on many families, this could represent a systemic legal and financial problem with far-reaching consequences. If these suspicions are confirmed, this could become one of the most significant medical and insurance-related scandals of our time. Can you confirm whether this risk exists within your organization’s network of clinics?

Clinical Psychologist: “Transition Does Not Lead to Happiness”

Beyond ignoring family input, there is another concerning issue. The treating clinical psychologist in this case repeatedly stated: “Transition does not make you happy.” This statement was recorded multiple times and is in the possession of a lawyer.

When a medical professional within the clinic acknowledges that medical transition does not guarantee improved well-being, it raises serious ethical concerns about the justification for such treatments. Gender transition is an irreversible intervention with significant, often life-altering consequences, including permanent bodily changes and lifelong medical dependency.

8 - If a specialist openly admits that transition does not necessarily improve well-being, what then justifies this treatment?

Call to Action

I request a substantive response within four weeks to the following questions:

Are you willing to question the clinics you work with about the critical concerns raised in this letter?

What review mechanisms do you have in place to ensure that reimbursement claims in this sector are based on an objective and careful diagnostic process?

What corrective measures will you take if it is found that gender clinics are using diagnostic codes without sufficient medical justification?

If I do not receive a response within this period, I will escalate this matter to relevant regulatory authorities, policymakers I am in contact with, and media outlets that are closely following this issue.

I look forward to your response. Please do not hesitate to reach out if you have any questions.

Sincerely,

Name:

Parents of:

Attachment: The scientifically designed Genspect survey, available at: https://genspect.org/resources/gender-dysphoria-support-tool/