Medical Gender Transition in Children – American Academy of Pediatrics Headquarters vs. the World

Courtesy American Academy of Pediatrics

by James C. Sherlock

Who cares for transgender kids the most and is looking out for their best interests?

  • The American Academy of Pediatrics (AAP) headquarters leadership; or
  • Dissenting AAP members and the medical societies of some of the leading nations in the science of medicine?

A reasonable and important question, since Virginia and the rest of the nation need to know what is best for kids before we squabble about who chooses.

An op-ed in The Wall Street Journal by pediatrician Dr. Julia Mason and Leor Sapir, a fellow at the Manhattan Institute, pulled back the curtain on the politicization of AAP headquarters and its suppression of debate on matters of medical treatment of children diagnosed with gender dysphoria.

They take on the efforts by AAP to suppress:

  • both public knowledge of the gaps in the science of child transgender medicine; and
  • efforts in conservative states to regulate on-demand puberty blockers, cross-sex hormones and surgery in children.

Importantly, they revealed that Sweden, Finland and the U.K. have enacted restrictions on medical transition of minors and that medical societies in France, Belgium and Australia are on the verge of doing so.

What do the medical societies and government health services in those countries know that the AAP does not permit discussion of and its scriveners in the American press have not reported?

To quote the WSJ op-ed:

A spate of headlines this month declared that America’s surge in transgender identification wasn’t being caused by a social contagion. These articles were prompted by a new study by Jack Turban and colleagues in Pediatrics, flagship journal of the American Academy of Pediatrics. The study claimed that social influence isn’t the reason that as many as 9% of America’s youth now call themselves transgender.

The authors call the headline-grabbing study:

…deeply flawed and likely couldn’t have survived a reasonable peer-review process. The swift response from the scientific community made both points clear—with even those who support hormones and surgery for gender-dysphoric youth noting that Dr. Turban’s shoddy science undermined their cause.

A low-stakes faculty lounge spat? Not really.

…the media have promoted his work as a refutation of the claim that the wildfire spread of transgender identity is an example of social contagion—a phenomenon in which members of a group (mostly young and female) mutually influence one another’s emotions and behavior.

Not social contagion?

Dr. Turban has not publicly rejected the theory that the epidemic is the result of a Chinese virus. (This is true, but it is also true that there is no such theory, so he was not asked about one. See how that works?)

Turban, a psychiatrist, has a distinguished academic CV and is a media darling. He is a member of the media committee of The American Academy of Child & Adolescent Psychiatry and the communications council of the American Psychiatric Association.

He is an incoming Assistant Professor of Child & Adolescent Psychiatry at the University of California, San Francisco. The same UCSF whose hospital offers transgender services to three-year-olds.

He should be happy there.

The authors contend that the AAP

…has been giving Dr. Turban a platform for years, despite the mistakes that plague his research. Pediatrics published his highly flawed 2020 study alleging that puberty blockers reduce suicide in teens.

The journal even chose the article as its “Best of 2020” despite receiving rebuttals that pointed out the rate of attempted suicide was twice as high among the puberty-blocked group and Dr. Turban hadn’t controlled for the possibility that better mental-health outcomes might be the result of factors other than hormonal intervention.

The editor of Pediatrics, the AAP journal, said he gave the award based on clicks and downloads, not “editorial choices.”

In response to a rebuttal from one of us (Julia Mason), who warned that the AAP was encouraging the misleading idea that sex can literally be changed, a reviewer said that her statement shouldn’t be published as it could be “offensive to the pediatric readership of the journal.” Pediatrics seems to be basing its editing choices on political calculation and the sensibilities of trans-identified teens.

I was informed by that, but not surprised. My own research over the past couple of years has exposed me to the gulf between opposing sides not only of the public debate, but also within elements of the psychiatric and pediatric communities on this issue.

The authors accused AAP of having been captured by child gender transformation devotees. I have noticed in these devotees a combination of messianic fervor, veils of secrecy in their medical practices, and a drive to suppress opposing views.

Plus progressive pediatricians, pediatric endocrinologists and surgeons clearly think it is cool medicine.

Cooler than treating runny noses.

On the suppression-of-debate front, again from the WSJ op-ed:

Last year a resolution was submitted to the AAP’s annual leadership forum to inform the academy’s 67,000 members about the growing international skepticism of pediatric gender transition. It asked for a thoughtful update to the current practice of affirmation on demand.

Even though the resolution was in the top five of interest based on votes by members cast online, the AAP’s leadership voted it down. In their newsletter, they decried the resolution as transphobic and noted that only 57 members out of 67,000 had endorsed it.

The following year, however, when only 53 members backed a resolution that supported affirmative intervention, the AAP allowed the motion to go through, saying that the previous year’s measure was “soundly defeated” while this year’s received “broad support.” When members submitted another resolution to conduct a review of the evidence, the AAP enforced for the first time a rule that shut down member comments, effectively burying it.

As I said, my experience in researching the AAP website matches that of Dr. Mason. I have never read a discouraging word there about puberty blockers, cross-gender hormones or surgery in treatment of gender dysphoric children.

So much for the backstage politics that taint the professionalism of the AAP and therefore the public debate.

The real news was that other science-driven medical societies around the world have placed severe restrictions on medical transition for minors.

The extensive review in the U.K. by its National Health Services of its Gender Identity Services for children and young people begun in late 2020 is perhaps the most concerning. It has been very extensive and the most up-to-date.

I will follow this article with a dive into the current status of that review.

Suffice it to say for the moment that it has uncovered gaping holes in the science of transgender medical transitions in children and pointed out that the procedures continue without sufficient scientific evidence.

Bottom line, all of this brings into great question the AAP’s suppression of debate.

And into great question whether what is being done with puberty blockers and cross-gender hormones in certain pediatric medicine practices today in this country could survive the same kind of review ongoing in Britain.