The American Academy of Pediatrics (AAP) has been confronted with sharp criticism from medical professionals for their policy pushing puberty blockers, cross-sex hormones and surgeries on transgender-identifying minors, and stifling debate over a more cautious approach.
The AAP fully endorses "gender-affirmation" care, while rejecting other forms of treatment for minors experiencing gender distress, including the more cautious "watchful waiting" approach. The gender-affirmation model prevents medical professionals from questioning a child’s self-reported transgender identity, and from exploring possible underlying factors causing their dysphoria. The standard protocol for gender affirmation is administering puberty blockers, followed by cross-sex hormones and then surgery, if desired.
"There are other ways to treat gender dysphoria, and AAP seems to be ignoring these other approaches," said Stella O’Malley, a psychotherapist and member of Genspect, a global coalition of clinicians and parents and advocacy groups that strives for an evidence-based approach to gender distress.
O’Malley told the Daily Mail that the AAP’s policy of immediately affirming a child’s selected gender, rather than investigating any underlying psychological problems, often has them "fast-tracked" into the "nuclear option" of drugs and hormones that place a "heavy medical burden on the body," leading to sterility, anorgasmia, osteoporosis and other severe side effects. Adding that many who underwent these treatments later wished "they’d gone for a gentler approach."
Even Dr Erica Anderson, a transgender clinical psychologist who has seen hundreds of teenage patients seeking medical transition, recognizes the social influence that has seen numbers of trans-identifying teens skyrocket.
"Millions of school-age American children have been shut at home during the Covid-19 pandemic, bombarded by online influencers telling them typical adolescent body-image anxiety is a sign of being trans," she said. "This is persuasive to impressionable, insecure young people who are searching for answers," adding that the AAP approach struggles to differentiate between "gender-questioning youth and persistently transgender youth."
A formal request to review the AAP’s policy was submitted by five of their own members, pediatricians, who in March of this year, requested a thorough and systematic evaluation of the available evidence to update their position. But a new rule prevents pediatricians from contributing to the discussion.
Genspect accused the AAP of "preemptively suppressing debate by not allowing comments," a rule they say that did not exist last year. The AAP’s Annual Leadership Conference meets at the Chicago Westin Northwest on Thursday.
While the US under the Biden Administration is moving full steam ahead to allow children unmitigated access to medical transition, several European countries like Sweden and Finland have changed course to a more cautious approach.
Sweden’s National Board of Health and Welfare (NBHW) released new guidelines for treating young people with gender dysphoria. "The NBHW deems that the risks of puberty suppressing treatment with GnRH-analogues and gender-affirming hormonal treatment currently outweigh the possible benefits, and that the treatments should be offered only in exceptional cases."
Finland’s Council for Choices in Health Care (COHERE) came to almost the exact same conclusion a year earlier, saying that: "The first-line intervention for gender variance during childhood and adolescent years is psychosocial support and, as necessary, gender-explorative therapy and treatment for comorbid psychiatric disorders." They further state that: "In light of available evidence, gender reassignment of minors is an experimental practice."
Gender reassignment medical interventions "must be done with a great deal of caution, and no irreversible treatment should be initiated," COHERE wrote.
Britain’s National Health Service (NHS) also recently changed its stance on puberty blockers as being "fully reversible" to an admission that their long-term effects are unknown.
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