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How should we care for minors who worry that their gender identity doesn’t match their biological sex? The answer has become more contested than ever as the proportion of young people who identify as transgender or nonbinary increases in leaps and bounds. Read arguments and responses on this issue from experts, pediatricians and other Journal readers.
The American Academy of Pediatrics’ Dubious Transgender Science | Aug. 17
The AAP has stifled debate on how best to treat youth in distress over their bodies, shut down efforts by critics to present better scientific approaches at conferences, used technicalities to suppress resolutions to bring it into line with better-informed European countries, and put its thumb on the scale at Pediatrics in favor of a shoddy but politically correct research agenda. Its preference for fashionable political positions over evidence-based medicine is a disservice to member physicians, parents and children. . . .
Julia Mason,
a pediatrician, is director of the Society for Evidence-based Gender Medicine.
Leor Sapir
is a fellow at the Manhattan Institute.
Academy of Pediatrics Abandons the Children | Aug. 22
I read Julia Mason and Leor Sapir’s op-ed in disbelief. How can minors be allowed to make such monumental life-changing decisions when their brains aren’t yet fully developed? There is a reason that children aren’t allowed to vote, drive and drink until they reach a more mature age.
There will come a time when we look back in horror at the damage done to these children, but it will be too late for the youngsters who were allowed by adults, and perhaps encouraged, to take puberty blockers and mutilate their bodies.
Sylvia Hernandez
Duck Key, Fla.
I searched online for the AAP diagnostic criteria for the disorder. I couldn’t find any. Instead, I found the 2018 AAP policy statement advocating affirmation of the self-diagnosis as the recommended approach due to the high suicide rate in this patient population.
The treatment is surgery and hormone administration. If the diagnosis is incorrect, it is mutilating surgery. But with no diagnostic criteria—except the minor’s statement—there is no differential diagnosis. So, the diagnosis is always correct. . . .
Joseph T. Marion,
M.D.
Carlsbad, Calif.
After over 30 years as a fellow of the AAP, I resigned my membership over its extreme positions. I’d wager many other pediatricians have as well.
Tim Eichenbrenner,
M.D.
Charlotte, N.C.
Read the full letters here.
Academy of Pediatrics Responds on Trans Treatment for Kids | Aug. 21
The American Academy of Pediatrics advises pediatricians to offer developmentally appropriate care that is oriented toward understanding and appreciating the youth’s gender experience. This care is nonjudgmental, includes families and allows questions and concerns to be raised in a supportive environment. This is what it means to “affirm” a child or teen; it means destigmatizing gender variance and promoting a child’s self-worth. Gender-affirming care can be lifesaving. It doesn’t push medical treatments or surgery; for the vast majority of children, it recommends the opposite. . . .
Meanwhile, the anti-trans bills in state legislatures, the social-media attacks and the rise in misinformation has an impact. The ones who suffer are the young people who are trying only to live their lives as their true selves. The AAP will continue to stand up for all children and adolescents, including those who are transgender.
Moira Szilagyi,
M.D.
President, American Academy of Pediatrics
Read the full letter here.
A Rare Reversal on Gender Transition Policy | Aug. 23
We are thrilled that the American Academy of Pediatrics (AAP) agrees that the “vast majority of children” who get “gender-affirming care” shouldn’t be treated with hormones and surgery, and in fact, need “the opposite.” Today, however, when pediatricians refer gender dysphoric minors to gender clinics for assessment, they are effectively sending them to be medically transitioned. . . .
Julia Mason, M.D., and Leor Sapir, Ph.D.
Portland, Ore., and Boston
Read the full letter here.
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