For the fourth consecutive year, a group of pediatricians submitted a resolution requesting that the American Academy of Pediatrics (AAP) take an evidence-based approach to treatment recommendations for gender-confused minors. What excuse will the AAP use this year to reject the most fundamental principle of evidence-based medicine? To base treatment recommendations upon unbiased, reproducible evidence – a “systematic review of the evidence”? This review is crucial since the medical harms for getting it wrong are so extreme.
The AAP promotes the aberrant “Gender Affirmation Model” in which the child announces his gender, which must be affirmed, whether it is the opposite sex or one of the ever-increasing number of non-binary genders. The child then directs whichever gender intervention fits his or her desired body modification. This intervention is facilitated without delay or question by the medical provider because the child “knows who he is.”
All age requirements have been abandoned. Per the AAP’s policy, a policy riddled with egregious misstatements, gate-keeping, exploring causality for the incongruence and “watchful waiting” are conversion therapy, suicidal-inducing, and an assault on a child’s bodily autonomy. Never mind that a child is not developmentally capable of comprehending the long-term, irreversible consequences of chemical and surgical sterilization or loss of sexual function. In no other medical milieu is a child’s self-diagnosis affirmed.
The AAP has consistently offered feeble justifications for rejecting a systematic review. It has called the mere request for this scientific endeavor, “transphobic,” equating valid concerns about a policy that recommends minors undergo extreme body modifications with an irrational fear of transgender people. Is it “phobic” to demand the highest standard of evidence when irreversible, life-altering treatments are the medical pathway?
Last October, Our Duty, a parent group, held a peaceful rally at the AAP’s annual convention. Participants, largely parents and detransitioners, held signs bearing messages such as “Democrats against Puberty Blockers,” “Surgery Does Not Cure Depression,” and “No One is Born in the Wrong Body.” They offered packets of evidence-based materials, but the AAP, preferring its members remain ignorant, instructed members to avoid them.
Following the rally, concerned parents and friends sent 121 letters to AAP President Dr. Moira Szilagzy and President-Elect Dr. Sandy Chung, requesting a systematic review. No one received a response. The letters, from 27 different states and largely from registered Democrats or those who’ve recently left the party due to gender politics, were rich with data. Had the AAP wanted to understand what it is best for gender-confused minors, they would have been exceedingly interested.
Of the 67 families who shared that their child had not been socially or medicalizing transitioned, 37 had children who desisted or were showing signs of desistence–returning to being comfortable in their unmodified bodies. This well-known phenomenon was carelessly discarded in the AAP’s policy statement as “outdated.” The AAP cast aside the only long-term studies on desistence, studies that mirrored the lived realties shared in these letters. These studies demonstrate that an average of 85% or more of the youth the AAP considers transgender or gender diverse will outgrow their discomfort with their natural bodies, with a significant percentage of them being gay or bi-sexual.
Yet another letter went out to AAP leadership in December. In this case, thousands of parents of gender-confused children (represented by Our Duty, Advocates Protecting Children, and Partners for Ethical Care) and a group of detransitioners implored the AAP to conduct a systematic review of the evidence with an added request to include them in the discussions.
The joint letter pointed out that the AAP’s policy author, Dr. Jason Rafferty, may have had financial incentives in promoting medicalization of children. The letter addressed the stark departure from the historical predominance of males identifying as transgender flipping to being predominately female cohort, the exponential growth in teens identifying as a gender unaligned with their sex – a social contagion spread among friend groups at a frenetic pace.
The letter raised concerns about the more than doubling of minors initiating puberty blocker treatments or starting cross-sex hormones over the 5-year period ending in 2022. It discussed the results of the systematic reviews performed by England, Sweden and Finland —countries which found that there is a significant lack of evidence to support medical or social transition. A few weeks ago, Norway announced that it will conduct a systematic review.
The parents and detransitioners informed the AAP of a Change.org petition, with over 1,500 signatures asking for a systematic review. The letter referenced a statement of concern from an FDA investigator involved with approval of Lupron as a cancer treatment regarding use of this powerful drug to block puberty.
The letter was ignored.
Our Duty mailed information on the prevalence of detransition, the harmful medical effects of hormones, and why transgenderism is different than being gay to AAP leadership, and included links to documentaries that detailed the experiences of detransitioners.
Our Duty dissected the false rhetoric on suicide. Of the 315 children in a study on the outcome of affirmative care treatments conducted by the most prominent pediatric gender clinics in the US, two children committed suicide within one year of hormonal treatments, more than 50 times the national suicide rate for minors. This NIH study dropped suicidality from the criteria it tracked, presumably because the results didn’t meet the “life-saving treatment” narrative. Despite the hyperbole, comprehensive data from the UK showed a suicide rate of .03 percent over eleven years (2010-2020), with no difference between those youth treated or untreated with gender intervention. And of the thousands of non-affirmed children in our parent groups, none have committed suicide.
This April, Our Duty emailed the AAP the results of the Woman’s Liberation Front’s petition, which gathered over 1,430 signatures. This petition requests reversal of the AAP’s “gender affirmative care” policy.
The AAP seems willing to sacrifice what is left of its reputation to its ideological members and those reaping the financial rewards of the multi-billion-dollar medical boom that is Gender Affirmative Care. Until it gets hit with multi-million-dollar judgments for fraudulently promoting a policy it knows cannot withstand scientific scrutiny, the AAP will continue to deflect on performing a systematic review of the evidence, irreversibly harming tens of thousands of children.
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