Evaluations › Levine · Last reviewed 2026-05-16
Levine et al. — critiques
Summary
Stephen B. Levine MD (Case Western Reserve University) was co-author of a series of articles in the Journal of Sex & Marital Therapy arguing that the informed-consent model of the Dutch Protocol is inadequate for irreversible interventions in minors, and that the cohort assumptions of de Vries 2014 cannot be generalised to contemporary adolescent populations.
Key publications
- Levine SB, Abbruzzese E, Mason JW. Reconsidering informed consent for trans-identified children, adolescents, and young adults. J Sex Marital Ther. 2022;48(7):706–27.
- Abbruzzese E, Levine SB, Mason JW. The myth of "reliable research" in pediatric gender medicine. J Sex Marital Ther. 2023;49(6):673–99.
- Levine SB. Reflections on the clinician's role with individuals who self-identify as transgender. Arch Sex Behav. 2021;50:3527–36.
Lines of argument
- Informed consent: according to the authors, disclosure of unknown long-term effects is incompatible with valid consent in minors.
- Generalisability: the contemporary population (later onset, more often biologically female, higher comorbidity) differs from the Dutch original.
- "Watchful waiting" as alternative: the authors advocate psychological care as a first-line approach.
See also
- Criticised consent structure: Informed consent in the Dutch Protocol
- Criticised inclusion criteria: Inclusion criteria
- Criticised study: de Vries 2014
- Broader methodological criticism: Methodological criticism
- Ethical context: Ethical criticism
- People register — Levine, Abbruzzese, Mason.
- International comparison — policy in table form.
- Timeline — Levine publications in chronology.
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