Johan Bester is a physician and bioethicist. Bester believes transgender minors “lack the autonomy” to consent to their healthcare.
Bester commented on the Trump Administration’s 2025 US HHS report attacking gender affirming care, saying “It is well written, methodologically rigorous, and makes a significant contribution to the discussion on this topic.”
Background
Johan C. Bester attended Stellenbosch University, earning a medical degree in 2002 and completing an internship at Groote Schuur Hospital in 2003. Following a mandatory one-year service role at Amajuba Hospital, Volksrust, Bester served as a physician at Royal Hampshire County Hospital in Winchester, UK. In 2006, Bester returned to South Africa, serving as an emergency room physician at Vergelegen Mediclinic in Cape Town. In 2007, Bester trained in family medicine at University of the Free State in Bloemfontein, then returned to ER work at Vergelegen until 2009.
During this time, Bester returned to Stellenbosch University, earning a master’s degree in 2009 and a doctorate in 2016.
In 2009 to 2011, Bester served as a family physician at Northern Medical Services, University of Saskatchewan. From 2011 to 2012, Bester served as a family physician at Oasis Medical Clinic in Airdrie, Alberta. Bester was appointed Clinical Assistant Professor in 2012 at University of Calgary Department of Family Medicine and began getting more involved in bioethics, serving until 2015.
In 2015 Bester began a fellowship in bioethics at Cleveland Clinic. In 2017 Behar was named Director of Bioethics Director of Bioethics at University of Nevada-Las Vegas, and in 2020 was named Interim Assistant Dean, Biomedical Science Education. Behar left UNLV in 2022 to serve as Associate Dean for Preclerkship Curriculum at Saint Louis University.
Anti-trans activism
In a 2024 reply to Moti Gorin, Bester wrote:
Minors generally lack sufficient autonomy to make significant medical decisions or major life decisions. For this reason, parents are generally their decision-makers, working with medical professionals to choose treatments that serve the best interests of the minor. Medical care in minors is justified by beneficence, not autonomy, and this should be no different for gender-affirming care. This severely undermines autonomy-based arguments for provision of gender-affirming care to minors. Given the lack of conclusive evidence for benefit, the nature of the treatment, and the fact that gender dysphoria in minors resolves spontaneously in most cases, there is presently insufficient justification for provision of such care to minors.
References
Gaffney, Theresa; Merelli, Annalisa (November 19, 2025). HHS names authors and releases peer review comments for gender dysphoria report: Original study of gender-affirming care was criticized for concealing contributorsā conflicts. https://www.statnews.com/2025/11/19/hhs-gender-affirming-care-report-authors-named/
Coverage in anti-trans press
Oliveira, Alex (November 19, 2025). Scientists okay Trump-ordered report that found almost nothing to support āgender-affirming careā for kids. New York Post https://nypost.com/2025/11/19/us-news/trump-ordered-report-that-found-almost-no-evidence-to-support-gender-affirming-care-for-kids-gets-scientific-seal-of-approval/
Selected writing by Bester
Bester Johan (July 11, 2025).Ā [Comments on evidence review, methods, and ethical analysis].Ā In Supplement to Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices Peer Reviews and Replies, pp. 11-19. https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report-supplement.pdf
Bester, J. C. (2024). Johan C. Bester replies: Hastings Center Report, 54(5), 34ā35. https://doi.org/10.1002/hast.4917
Bester, J. C. (2024). Minors Lack the Autonomy to Consent to GenderāAffirming Care: Best Interests Must Be Primary. Hastings Center Report, 54(3), 57ā58. https://doi.org/10.1002/hast.1600
Resources
LinkedIn (linkedin.com)