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This is a timely and important perspective piece on the current explosion of transgender children in western countries and the many risks associated with gender-affirming treatment of children and young people. Most worryingly, childhood gender dysphoria and its treatment is presented to us as though it is fully supported by the science and research data. This is not the case - if anything, most of the data are weak and many issues which raise doubt about gender-affirming treatment, such as the high desistence rate, and high post-operative suicide rate, are left out. At the same time, US gender experts are pushing for younger and younger ages for cross-sex hormone treatment and surgical genital modification. This is a discussion we need to have and it needs to be based on facts.