Speakers: Dr. Ryan Cole, Dr. Kimberly Milhoan, Dr. Katherine Welch
As gender transition procedures among youth become more common, a growing number of doctors are raising serious concerns—medical, ethical, and human rights alike. Can minors truly consent to irreversible medical interventions? Urgent questions demand honest answers.
This week, IMA Senior Fellow Dr. Ryan Cole hosts a powerful panel featuring IMA Senior Fellows Dr. Kimberly Milhoan and Dr. Katherine Welch. Together, they’ll lay out the medical case against transitioning minors—from the lack of informed consent to the long-term physical and harm. psychological Both guests bring deep clinical experience serving children and vulnerable populations—and both are sounding the alarm.
Gender transition procedures for minors have moved from fringe debate to frontline policy in a matter of years. But while mainstream institutions increasingly endorse these irreversible interventions, many doctors are raising serious concerns. What if the medical model now being pushed is causing more harm than healing?
In this urgent IMA webinar, Senior Fellow Dr. Ryan Cole sits down with Dr. Kimberly Milhoan and Dr. Katherine Welch—two experienced physicians with decades of pediatric and humanitarian practice. Their message is clear: we are failing our children. From compromised consent to long-term physical and psychological harm, this conversation lays out the medical case against transitioning minors.
This discussion builds on a panel first hosted at the 2025 IMA Conference on the same topic, going deeper into a clinical and ethical examination of what “gender-affirming care” really means in practice. Far from politicized rhetoric, the doctors root their insights in firsthand experience, sound science, and a commitment to protecting vulnerable youth.
Meet our Expert Panelists
This webinar features two IMA Senior Fellows who bring deep medical and humanitarian credentials to the conversation. Their expertise spans pediatrics, anesthesia, public health, and human rights—making their insights into this complex issue especially important.
Dr. Kimberly Milhoan, FASA
Dr. Milhoan is a board-certified Pediatric Anesthesiologist based in Kihei, Hawaii. She completed her undergraduate studies at Stanford, attended medical school at UC Davis, and served as chief resident at UTHSCSA. A Fellow of the American Society of Anesthesiology, she is also the co-founder of For Hearts and Souls, a nonprofit providing cardiac care to children worldwide.
Dr. Katherine Welch
Dr. Welch is a pediatrician specializing in health and human rights. A graduate of Indiana University School of Medicine with residency at UAB, she has served marginalized populations for over two decades across Asia and Europe. She is the founder of Imago Dei Restorative Health and Relentless, organizations supporting survivors of trafficking and individuals recovering from gender-related medical interventions.
A Closer Look at Issues Transitioning
There are five key reasons these IMA physicians believe current gender medical protocols are harming minors rather than helping:
- Irreversible Harm: Physical and Psychological
- Informed Consent and the Maturity Gap
- Long-Term Harms of Transitioning
- Social Influences and Gender Dysphoria
- The Problem with “Affirmation”
1. Irreversible Harm: Physical and Psychological
The panelists began by addressing a crucial aspect often glossed over in mainstream conversations: the irreversible nature of medical interventions for gender transition in minors.
Procedures such as puberty blockers, cross-sex hormones, and surgical alterations permanently disrupt normal physical and psychological development. The medical community promoting these procedures frequently frames them as compassionate care, yet the reality, as emphasized by the panel, is significantly more troubling.
Dr. Welch states the reality plainly:
“These surgeries have a 70% complication rate, like an adverse complication—not just regular adverse—70% adverse complication rate. That means, well, the surgery didn’t go quite as planned.”
It’s worth repeating clearly: 70% of gender-affirming surgeries have adverse complications. If an airplane had a 70% failure rate, no reasonable person would step on board. So why are we steering vulnerable children toward procedures with such alarming risks? Before encouraging these life-altering interventions, shouldn’t we pause to consider the profound, lasting consequences they carry?
2. Informed Consent and the Maturity Gap
Can a child truly give informed consent for a decision that will affect their body for the rest of their life?
Dr. Welch emphasized that informed consent is more than just signing a paper—it requires genuine understanding, freedom from pressure, and emotional and cognitive maturity. These critical elements are absent in the current approach to treating gender dysphoria in minors.
Dr. Milhoan clearly underscores the limitations of informed consent in minors:
“That’s what I’m curious about—even adults, are they truly getting informed consent? I mean, anyone that’s had surgery—right? I’m an anesthesiologist; I take care of people who have surgery all the time… So that is my curiosity: are even the adults truly getting informed consent about the level of complications of these surgeries?”
3. Long-Term Harms of Transitioning
The panelists discussed at length the severe, often unexpected, long-term harms reported by individuals who underwent medical transition as minors.
These consequences include significant bone loss, infertility, lifelong medical dependency, chronic pain, and profound psychological distress. Contrary to expectations that transition would alleviate their discomfort, many find themselves facing even greater dysphoria and suffering.
Dr. Cole emphasizes the severity of these lasting impacts:
“You know, once you’ve had surgery, what does the body always do? It scars. And if you try to create an opening, it always tries to close. So good luck making an incision anywhere and trying to keep that incision open. It’s always going to try to cover and close itself. That’s just a natural response of the human body.”
Dr. Cole further stresses that adolescents who undergo these interventions face long-term physical and emotional struggles with no clear roadmap for support or recovery, underscoring the urgency of reevaluating these irreversible treatments for young people.
4. Social Influences and Gender Dysphoria
The sharp increase in diagnosed cases of gender dysphoria cannot be understood as an isolated medical phenomenon. The panelists explained how various underlying issues—such as trauma, social pressures, peer contagion, family instability, and mental health conditions—often accompany or even drive the desire for gender transition in minors.
Dr. Katherine Welch speaking at the IMA 2025 conference.
Rather than properly identifying and addressing these root issues, the current medical approach increasingly channels children into irreversible interventions.
Dr. Welch highlights these crucial underlying factors:
“Instead of seeing gender dysphoria as the primary diagnosis, which is what is being put forward by the Academy of Pediatrics or any mainstream medical center… behind it is the depression, is the anxiety, is broken homes, is neglect, is autistic tendencies, things like that. And they’re not looking deeper than that.”
By failing to thoroughly investigate and manage these foundational concerns, the medical system risks causing further harm rather than facilitating genuine healing.
5. The Problem with “Affirmation”
The panelists highlighted a critical misrepresentation embedded in the concept of “gender-affirming care.” Although the phrase suggests kindness and support, the practical reality is far more restrictive and problematic.
According to the panelists, affirmation often translates into a singular medical trajectory—one that offers little room for exploring alternative viewpoints or addressing underlying psychological and emotional issues. In this scenario, affirmation becomes coercive, limiting genuine patient choice rather than enhancing it.
Dr. Welch powerfully articulates the contradiction inherent in this approach:
“Gender affirming care—which is another misnomer—it’s actually gender-denying care, sex-denying care. Gender affirming is actually affirming your natal sex.”
Instead of providing comprehensive, patient-centered care, the current affirmation model may inadvertently steer vulnerable minors onto an irreversible path of lifelong medical dependency, with significant and lasting consequences.
More Resources
For those looking to learn more or share with friends and family, here are trusted resources the panel recommended:
- HHS Gender Dysphoria Report: Read here
- The WPATH Files: Access here
- Epoch Documentary: Watch here
- Helping Detransitioners with Medical Needs: Go here
- IMA Conference Panel (2025): Watch now
Recommended Books
- Lost in Trans Nation by Miriam Grossman: Buy here
- Irreversible Damage by Abigail Shrier: Buy here
- The Anxious Generation by Jonathan Haidt: Buy here
Stay Connected with IMA
This conversation is just the beginning! IMA and our experts cover a range of topics across the medical spectrum. Stay informed and support IMA’s mission to protect patient rights and medical ethics:
- 🏩 Check out the revamped IMA store: Shop now
- 🎧 Watch the latest Whole Body Health episode on Vitamin B: View here
- 📚 Visit our new mRNA Resource Center: Explore now
