The question of whether, when, and how children and adolescents with gender dysphoria should be treated medically or surgically is contentious. Gender dysphoria in the United States is being treated with “gender affirming care,” which may include gonadotrophin releasing hormone analogues (GnRHa) to suppress puberty, oestrogen or testosterone to promote secondary sex characteristics, and surgical removal or augmentation of breasts, genitals, or other physical features. At the same time, several European countries have issued guidelines limiting medical intervention in minors and emphasizing psychological care. There is little doubt in the medical community that children in distress require care, but there are concerns about the rapid widespread adoption of interventions and calls for rigorous scientific review from all corners.