Stifling Debate on Transgender Dysphoria


We are losing faith in our healthcare institutions. It seems this is another consequence of political correctness.

I have written frequently of my loss of faith in the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), especially since the Biden administration took office. Frequent reversals of their guidance can only be attributed to political, rather than scientific, decisions. I have also distanced myself as a physician from the American Medical Association (AMA) due to their liberal and unscientific policies. I am not alone in this view – the AMA today represents only about 12% of all U.S. physicians. (The AMA Doesn’t Represent Most Doctors)

Now, it seems, the pediatricians cannot have much faith in their specialty organization, the American Academy of Pediatrics. Rather than promote the healthy and urgently needed debate on gender dysphoria, the AAP has refused to consider other opinions. Gender dysphoria is ruining the lives of many young people in their most vulnerable years of development. But instead of being a lighthouse for discussion of this sensitive topic, the AAP has chosen to promote the darkness.

Abigail Shrier, author of The Transgender Craze Seducing Our Daughters, writes of the AAP’s intransigence in The Wall Street Journal. It seems they don’t tolerate dissension in their ranks. A group of pediatricians calling themselves the Society for Evidence-Based Gender Medicine (SEGM) requested a booth at the upcoming annual convention of the AAP. They were granted their request at first, but later the AAP rescinded their approval without explanation.

The SEGM is an international consortium of clinicians and researchers who doubt the reigning orthodoxy that is promoted by the AAP.  They believe important questions like, “Is it safe for adolescents to undergo gender ‘transition’? Is it wise for children to take hormones that block puberty? should be discussed and debated. The AAP accepts these ideas and won’t allow the debate.

This is especially alarming since many other countries are reversing their policies on these issues after bad experiences. In the past year, major hospitals in Europe have ended or curtailed pediatric hormone treatments in response to their own internal reviews. In March, the U.K.’s National Institute for Health and Care Excellence concluded that the benefits of hormone treatments for pediatric gender-dysphoria patients were unclear. The Karolinska Hospital of Sweden, which is affiliated with the Nobel Prize in medicine, in May decided to end its use of puberty blockers and cross-sex hormones for treatment of gender dysphoria for all patients under age 18, except in controlled research settings. Finland has made similar recent changes.

Despite these policy reversals, and skepticism among clinicians across the West, “there’s no home for that message inside U.S. medical societies” says endocrinologist and SEGM co-founder Will Malone.

Current recommendations by the AAP follow the so-called Dutch Protocol, a widely adopted standard of care that has been used to justify starting gender-dysphoric minors as young as eight years on puberty blockers. This protocol is based on a narrow population: children with severe gender dysphoria since early childhood and no other mental-health comorbidities. But now the protocol is being applied to a much broader demographic – teenage girls who seem to have had no prior history of dysphoria and who have high rates of anxiety and depression.

Many of these same girls now regret their entry into this protocol and call themselves “detransitioners.” But the AAP is “working very hard to give an appearance that everything’s been decided and there’s no debate. The growing numbers of detransitioners suggests that pediatricians don’t really know what we’re doing in this case,” said Julia Mason, a pediatrician, SEGM adviser, and AAP fellow.

“We show up with a valid argument, we’re not politically or ideologically driven,” Dr. Malone said. “Other countries, more liberal countries, have already come to the conclusion that we should have come to as a country years ago. And yet, because we can’t open this debate in any form. . . the debate is not occurring and kids are being harmed.” The SEGM didn’t even apply for the opportunity to debate current protocols; they simply wanted to staff a booth and hand out materials.

It seems that pediatricians are finding the AAP as poor a representative of their views as most physicians find the AMA.

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