Doctors dispute Rachel Levine's claim that 'there is no argument' about gender-affirming care among medical professionals

"They're trying to make it seem that the evidence base is a done deal and is settled science, and that's just simply not the case," Dr. William Malone said.

Hannah Nightingale Washington DC

Several medical professionals are pushing back against a recent claim made by Assistant Secretary of Health Rachel Levine, who said that "there is no argument" about gender-affirming care among medical professionals who specialize in those under 18.

They told Fox News that many of their colleagues fear speaking out publicly against transgender ideology over concerns of professional and personal retaliation.

Medical professionals, including the Florida Department of Health, took issue with Levine’s claim.

In April, citing a number of peer-reviewed studies and a "lack of conclusive evidence, and the potential for long-term, irreversible effects," Florida Surgeon General Joseph Ladapo released a fact sheet advising against the HHS’s list of potential treatment options for young Americans with gender dysphoria.

In an interview with NPR last month, Levine, who is a transgender female, said "there is no argument among medical professionals – pediatricians, pediatric endocrinologists, adolescent medicine physicians, adolescent psychiatrists, psychologists, etc. – about the value and the importance of gender-affirming care."

That HHS fact sheet said that "gender-affirming care" includes social affirmation, puberty blockers during puberty, cross-sex hormone therapy starting during early adolescence.

It adds that irreversible surgery is "typically used in adulthood or case-by-case basis in adolescence," according to the agency.

Ladapo’s office told Fox News that  "the burden of proof to support the outlandish claims made on NPR falls on Dr. Levine."

Levine's office affirmed the assistant secretary's claims when questioned by Fox News: "There is no debate in the medical community about the medical or scientific validity of gender-affirming care," Levine's communications director Adam Sarvana told Fox News.

According to Fox News: "Sarvana said the standards of care from the World Professional Association for Transgender Health (WPATH) have been endorsed by multiple medical organizations, including the American Academy of Pediatrics (AAP), the American Medical Association (AMA), the American Psychiatric Association (APA) and the American Academy of Child & Adolescent Psychiatry (AACAP)."

Idaho-based assistant clinical professor of endocrinology, Dr. William Malone, is a member of the Society for Evidence-Based Gender Medicine (SEGM).

This international group of more than 100 researchers and clinicians have expressed concerns  about what claim is the "lack of quality evidence for the use of hormonal and surgical interventions as first-line treatment for young people with gender dysphoria."

This group released a rebuttal of the HHS guidance on April 7, stating that the department had failed to review available literature, and said that they made biased recommendations without considering the possibility of alternative treatments, the low quality evidence, or a diversity of clinician viewpoints.

Malone and several other colleagues issued a letter to the editor of The Journal of Clinical Endocrinology & Metabolism in March of 2021, in which they pointed out that the "standards of care" presented by WPATH and the ES are in all actuality only practice guidelines, which are potentially subject to the bias of their sponsor, Fox News reported.

ES countered Malone’s claims, forwarding to Fox News a published response they issued to Malone stating he and his colleagues "overstate concerns and conflate appropriately conservative statements from the existing literature with absence of data."

"They're trying to make it seem that the evidence base is a done deal and is settled science, and that's just simply not the case," Malone told Fox News. "And so the language that they're using does not reflect the actual medical evidence."

Malone noted that other countries are remaining cautious in regards to gender-affirming care, especially in the case of minors.

Countries like Sweden, Finland, New Zealand, and Australia have expressed showing restraint when it comes to issuing young children hormone treatments and other irreversible treatments, saying that other first-line treatments like psychotherapy.

One child and adolescent psychiatrist by the name of Dr. Miriam Grossman, who has treated young people for more than 40 years, said that Levine "is misleading the American public by claiming there is no disagreement among physicians regarding gender-affirming care," Fox News reported.

"There is a complete lack of high-quality, long-term data that these medical interventions actually help, and it is very disturbing to me as a fellow physician that Dr. Levine is arrogantly announcing that all pediatricians, all physicians and therapists agree with her position," said Grossman, who described the rising rates of gender dysphoria among young people as "a psychic epidemic."

"I attribute it to the gender ideology, which has made its way into our schools, into our entertainment industry, into the social media platforms. Children who have various emotional issues are being led to believe that being transgender is going to solve their emotional issues," she said, adding that especially among female adolescents, such ideas spread quickly amongst friend groups.

Dr. David Haralson, a Colorado-based marriage and family therapist who is part of a group called the Gender Exploratory Therapy Association (GETA), which encourages therapy instead of medical treatments and surgeries to help resolve gender dysphoria cases, told Fox News that there’s an "underground group" of clinicians that talk about their concerns regarding the subject.

"There's kind of like an underground group of therapists and pediatricians and doctors who have to meet in secret groups to talk about their concerns with this, because everyone kind of sees it as being transphobic if we challenge this narrative," he said.

Registered psychologist and lecturer at Ryerson University in Toronto Dr. Oren Amitay told Fox News that he believes that Levine’s claims are hyperbolic, given the number of medical professionals he knows worldwide that express doubt over the long-term safety of these gender-affirming treatments.

"We have a number of colleagues who say no, this is wrong, and it's not on ideological grounds, it's on the science," said Amitay, who also said that he and other doctors communicate these concerns through various groups.

"I don't know if we're in the minority, but we're definitely in hiding, so to speak, because speaking out can get us in trouble," he said. "So yes, there are quite a few of us who disagree."

Amitay, who resides in Canada, said that recent Canadian legislation like Bill C-4 has had a "chilling effect on his own practice," Fox News reported.

"I will tell you that in today's day and age, I'm less inclined to ask certain questions that I would have in the past, because I'm worried that it would be mischaracterized as conversion therapy," said Amitay.


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