Slick Selling of Child Gender Transitions at UVa Children’s Hospital

by James C. Sherlock

The University of Virginia Children’s Hospital offers a Madison Avenue-quality sales pitch for child gender transition.

As written and smoothly delivered, it deflects any reservation parents may have in supporting such transitions by telling them they have been misled or are being selfish or both.

It helps parents decide by blaming their reservations on myths.

I offer below both a video and a transcript of that sales presentation.

The presenter uses a variation on the closing technique called the “question close.” In this one she both asks the questions — identified as myths — and answers them. The presentation carefully avoids mention of the word sterilization.

I expect that, given the sensitivity of the subject, it is very likely the best technique for closing the sale. Brilliant even.

If that is your goal.

The reputation of UVa hospital likely will be damaged by this exposure of how it sells this particular product. They have earned it.

Throughout the rest, I add bolding emphasis. The parenthetical statements within the quotations are my own.

Go to For Parents & Caregivers of Trans Youth

First, see the tug on the parental heartstrings followed by soft-pedaling of the medical dangers.

Your Love & Care for Your Transgender Child

(Translation: No question – – your child is transgender.  We treat hundreds of patients a year. The diagnosis is a formality. “Our doctors need this letter in order to treat you, so, we’ll connect you to affirming mental health professionals”.  Affirming. This is only about whether you love him.)

Research shows that transgender teens thrive with support and acceptance. Their mental health improves with affirmation from loving parents and caregivers.

Puberty Blockers

For kids under 18, we offer puberty blockers. These hormones do not alter your child’s sex or cause harm. They do pause the growth of secondary sexual characteristics, like breasts and hair. This gives youth a chance to explore their gender identity. They can do so without the emotional baggage of puberty’s physical changes.


We prescribe sex hormones for transgender youth. These help kids who want to look and feel more like their gender identity.

Now you can watch the slick sales video, When Your Child is Transgender.

an outreach coordinator at the Transgender Teen Health Clinic walks us through 5 common myths about parenting transgender teens. She explains how communication, understanding, and respect can help rebuild and strengthen your relationship with your child.

I offer the official transcript of the presentation below. It drips with sales psychology.

Myth # 1 – It’s just a phase. My kid just wants attention.

Teenagers do want attention sometimes. And some of the things that teenagers do as part of their identity development may be a phase. Our experience is that saying that you’re transgender or realizing you are transgender is not often a phase.

And if all your child wants you to do is use the name and pronouns they’re asking you to use, there’s no harm done in doing that. As we go into medical interventions, we do more education about what’s reversible and what’s not. But dismissing it as a phase is not very respectful of your child. Particularly if your child is experiencing a lot of emotional distress around this.

Myth #2. Gender dysphoria is a mental illness

Because we do require a gender dysphoria diagnosis that sometimes people consider gender dysphoria a pathology that implies that something is wrong. Gender dysphoria does cause emotional distress that can manifest in anxiety, depression, and suicidal ideation. But gender dysphoria on its own does not signal that somebody is mentally ill.

Myth #3. Puberty blockers and hormones will harm my child and have lasting effects. (There is significant medical evidence that some of the hormones may do harm even beyond sterilization — a word never used — and none have been approved by the FDA for this use in children. But concerns are presented as myths nonetheless.)

I think it’s important to point out that any time you’re introducing medication, there is the possibility for side effects, but often those side effects pale in comparison to the emotional distress that somebody with gender dysphoria is experiencing. Puberty blockers are wonderful because they provide sort of a break, and their effects are reversible.

When someone starts cross-sex hormones like estrogen and testosterone, some of the effects of those medications are not reversible. Which is why we proceed cautiously and slowly when prescribing them. And we generally start with low doses.

Myth #4. Supporting my child would mean I approve of gayness and it would go against my religion. (Religion placed squarely in the myth-to-be-overcome category)

I hear this one a lot too, and often when I try to delve in what’s behind this statement, I find a lot of fear that they’re experiencing based on what they’ve been told by other family members or members of a faith community. And I point out to them that there are a lot of religious denominations who don’t have any problem with somebody identifying as LGBTQ+, and that they need to decide what is most important for their own child or children. A lot of our parents who are initially non-supportive become much more supportive once they see how well their children do when they’re able to be their true selves.

Myth #5. I am losing my child

One of the things that I gently try to point out to them is they’re making it about themselves and not about their child. (Gently telling parents they are selfish)

I can understand them perhaps feeling that way, and that may be something they can share with a therapist or a close friend, but it’s not an empowering message to convey to their children. These kiddos not only survive, but thrive. And I think the more affirming and empowering the messages they get from their parents, the better they’re going to do. (Kiddos – nice touch for humanizing the discussion)

Bottom line.

The closer plays on the emotions of the customers, parents, by presenting hormone treatments as gifts without which their children cannot “thrive.”

Puberty blockers are wonderful. They provide sort of a break.

Pity the child who gets left out. Like failing to catch the Good Humor truck.

But I have to say, given the topic and the customers, it is a great sales pitch. Mad Men quality.

Some will point out that the endocrinologists who do this are creating lifelong patients.  Transitioned children, men and women will need estrogen or testosterone for the rest of their lives.  Medically transitioned children have to be carefully handed off to an adult system of hormone maintenance. Many are sterilized by the treatments.

None of this is in the hard sell by UVa.

The staff who do this are clearly true believers.  They are smart, and this is how they have chosen to practice medicine.  There are too many people who are sure to despise them for what they do to choose this path lightly.

But even believing the procedures are a boon to mankind, selling them this way is wrong.  Snake oil comes to mind.  Additional undercoating.

UVa Hospital should be ashamed of itself. Even if they think they should provide this “service,” they deserve criticism for selling it like a used car.

I hope Virginia, which already requires a court order for surgical sterilization of children, extends that law to cover this procedure, which often leads to medical sterilization.

UVa Children’s Hospital should never have designed this cynical, insulting sales pitch, much less put it on video to welcome parents to child gender transformation.  It can either be a child health care facility or whatever this sales pitch represents.

The leadership will need to pick one.

Updated Sept 25 at 14:58