Establishment American medical associations have gone woke across a variety of issues, particularly what is called “gender-affirming care” for children with gender dysphoria. GAC includes social affirmation — using pronouns and new names for children who feel they were born the wrong sex — hormone administration/puberty blocking, which can have permanent consequences for the patient, and mutilating surgeries such as mastectomies for teenagers.
The problem for practitioners of transgender ideological medicine is that there is now significant pushback from doctors who practice in relevant specialties and from socially progressive countries such as the U.K., Sweden, Norway, Finland, and France that can’t be accused credibly of pushing social conservatism as policy. That makes the adamant insistence that gender-affirming care is the only and best approach far more difficult to maintain. So, the American Academy of Pediatrics has taken a half step back — validating its previous support but also willing to engage in deeper studies. From the New York Times story:
The American Academy of Pediatrics backed gender-related treatments for children on Thursday, reaffirming its position from 2018 on a medical approach that has since been banned in 19 states.
But the influential group of doctors also took an extra step of commissioning a systematic review of medical research on the treatments, following similar efforts in Europe that found uncertain evidence for their effectiveness in adolescents.
Critics across the political spectrum — including a small but vocal group of pediatricians — have been calling for a closer look at the evidence in recent years, particularly as the number of adolescents who identify as transgender has rapidly increased.
The treatments are relatively new, and few studies have tracked their long-term effects.
That last point is absolutely true, so the AAP’s continued support for GAC is more than problematic.
Moreover, the studies demonstrating the inadequacy of the available data have already been done. The U.K. reviewed the evidence and found that not only is gender dysphoria often “transitory,” but the data in favor of material benefits from gender-affirming care is wanting, while the risks are abundantly clear. Ditto, findings by health authorities in the other countries mentioned.
A report in the British Medical Journal has similarly weighed in against GAC as the priority approach, stating in part:
Without an objective diagnostic test [to diagnose gender dysphoria], however, others remain concerned. The demand for services has led to a “perfunctory informed consent process,” wrote two clinicians and a researcher in a recent issue of the Journal of Sex and Marital Therapy, in spite of two key uncertainties: the long-term impacts of treatment and whether a young person will persist in their gender identity. And the widespread impression of medical consensus doesn’t help. “Unfortunately, gender specialists are frequently unfamiliar with, or discount the significance of, the research in support of these two concepts,” they wrote. “As a result, the informed consent process rarely adequately discloses this information to patients and their families.”
Not only that, but a detailed study of the available studies on the question found that the data does not support GAC in children. Then, there is the de-transition phenomenon, about which one of the authors of that macro review, Stephen B. Levine, told me in my Humanize podcast:
De-transition has become much more visible in recent years. However, it was only recently that the rates of detransition began to be quantified. According to recent UK and US data, 10–30% of recently transitioned individuals detransition a few years after they initiated transition.
Clearly, the science is not settled. That being so, the responsible approach for the AAP would have been to call for a moratorium on GAC pending further inquiries. But a half step is better than nothing. Hopefully, we are seeing the beginning of the end for unquestioned gender-affirming care as the first response to a child who presents with gender confusion.