Inside Europe's Transgender Medicine System with Róisín Michaux
Róisín Michaux is an Irish journalist based in Brussels — an ideal vantage point from which to report on how gender medicalisation of minors functions across open European borders. Her undercover work, a visit to a Belgian youth clinic, and the discovery of Madrid surgeries for minors combine to make this one of the most directly relevant episodes for anyone following the debate from within the European Union.
Róisín Michaux brings a rare combination of perspectives to this conversation. An Irish journalist based in Brussels, she sits at the intersection of Irish civil society and the European institutional world, and she has spent considerable time investigating how gender medicine for young people actually functions in practice — not as it is described in policy documents, but as it operates on the ground, online, and across open borders. Her most striking investigative work involved going undercover while posing as a concerned adult accompanying a fictitious teenage girl — described as distressed and autistic — to see what services and pathways would be offered. What she encountered was a system that, in several instances, moved quickly toward medicalisation rather than psychological exploration. The episode walks through the methods she used, the responses she received, and what the experience revealed about the relationship between online communities and clinical referral pathways. From a European standpoint, two findings are particularly significant. The first is the role of cross-border prescribing: the episode examines how organisations such as Imago facilitate hormone prescriptions that reach young people across national boundaries, effectively bypassing whatever safeguards individual member states may have in place. The second is a visit to a youth clinic in Antwerp — a concrete reminder that Belgium, like many EU countries, has developed its own infrastructure for youth gender medicine, and that this debate is not confined to the United Kingdom or Scandinavia. Perhaps the most alarming detail for European listeners is the question of surgical access. Michaux's investigation identified clinics in Madrid prepared to perform mastectomies on minors. For parents, clinicians, and policymakers across the EU, this raises immediate questions: what oversight exists for cross-border medical travel within the single market? What happens when a family from Germany, France, or the Netherlands seeks a procedure that would face far greater scrutiny closer to home? These are not hypothetical concerns. The episode also examines the international framework that underpins much of this — the WPATH pipeline, the protocols shaping clinical training and treatment decisions, and the tension between suicide-prevention messaging and the affirmation-first model. The conversation touches on DIY hormone use and the proliferation of online clinics, both of which are growing concerns across continental Europe, where young people's access to unregulated services and peer communities mirrors what has been documented in other countries. For European listeners — whether in Stockholm, Amsterdam, Paris, or beyond — this episode is a detailed, reported account of how a system functions when left largely to self-regulate across porous borders. Michaux's position in Brussels gives her a particular sensitivity to the gap between EU-level rhetoric about protecting children and what actually happens when a distressed young person goes looking for answers online. The picture she paints is one that clinical associations, health ministries, and EU institutions would do well to examine honestly.
