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Objective: To stimulate debate as to whether gender affirming care is a governmental policy imposed upon psychiatrists in the early decades of the 21st century. Conclusion: Gender affirming care (GAC) is a highly controversial treatment approach for minors with gender distress. GAC possesses several unique features that potentially mark it as a political movement rather than a health intervention, including: its availability according to government policy rather than research evidence, clinicians being under perceived pressure to implement GAC, the required use of visual symbols and language to signal allegiance to the model in the workplace, and the involvement of activist organisations in guiding its implementation in health services. GAC aligns with historical examples of the politicisation of psychiatry in providing a sanitising cover for governments to enact an unpopular political agenda without appearing to rely upon overt forms of authoritarianism. Disguising GAC as a psychiatric treatment successfully stymied public debate by suggesting that psychiatrists have a degree of medical expertise regarding gender distress that the public lacks. Clinician dissidents to GAC face social pressures and fear risks to their employment and medical registration. Two recent Family Court judgments in Australia further demonstrate the mechanisms by which GAC is held in place by activist clinicians supported by a governmental agenda.

Keywords: gender affirming care; adolescents; politicisation of psychiatry; Family Court