Is President Trump pushing gender-confused kids to commit suicide? This shocking claim hit mainstream and social media within minutes of the president's Jan. 28 executive order banning federal funding for child sex-change treatments. The way the argument goes, if kids can't get puberty blockers, cross-sex hormones and surgeries, their mental health will deteriorate to the point of no return. But as I've seen while working with more than 1,000 such kids, there are deeper reasons why they're so unhappy " and giving them powerful experimental drugs and irreversible surgeries is more likely to worsen their condition. From 2018 to 2022, I worked as a case manager for the Washington University Transgender Center at St. Louis Children's Hospital. As kids kept coming back for follow-up check-ins and treatment " almost every kid who begins puberty blockers goes on to receive cross-sex hormones " I realized something was very wrong. When my colleagues and I asked about their mental health, they usually reported that it was the same or better. But as soon as we dug deeper, it became clear that the real answer was no " that their mental anguish was worsening. We ignored or explained away co-morbidities like autism, depression and bipolar disorder while using every new development or difficulty in a kid's life to justify continuing down the sex-change road. In my experience, kids typically find the "treatment brings happiness" mantra of their doctors, nurses and case managers hard to see through. Some literally couldn't look themselves in the mirror, even if they physically looked the part of a boy-turned-girl or vice-versa. While activists insist that kids simply "know who they are," reality is more complicated.