America’s top pediatricians have sparked controversy after suggesting that it is child abuse to deny gender-affirming care to minors.
The influential American Academy of Pediatrics (AAP) said that “denying gender-affirming care harms children and amounts to state-sanctioned medical neglect and emotional abuse.”
The AAP made the claim in a consensus statement released in late December, and the statement was in response to a wave of age restrictions on puberty-blocking drugs and surgeries for children in Republican states.
Although its views are not medically binding, the panel is made up of 70,000 of the nation’s top pediatricians and its recommendations are considered the gold standard.
But health care experts in other countries have called the AAP’s comments unethical and irresponsible because they focus more on the politics of the moment than on medicine.
views are not medically binding, the panel consists of 70,000 of the nation’s top pediatricians and its recommendations are considered the gold standard
Twenty-two states have introduced restrictions on children’s access to menopausal medicine, including puberty-blocking injections and hormone therapies
The US has become an outlier among most Western countries when it comes to treating children suffering from gender dysphoria – with Britain, France, Sweden and a host of other European countries all interrupting puberty and blocking drugs and surgery in minors until more is known about its consequences. their long-term mental and physical effects.
In the US, the issue has become a political lightning rod, with more than a dozen Republican states restricting children’s access to transition medicine and vowing to punish doctors and patients who allow it.
Meanwhile, blue states have portrayed themselves as liberal bastions for LGBTQ individuals by requiring insurers to cover certain services and offering legal protections to people traveling from restrictive states for treatment banned at home.
The official magazine of AAP Pediatrics That argument added that legislative efforts across the country to limit access to that care “operate under the guise of protecting children.”
“In reality, they punish caregivers and doctors when they choose to support children.
“They deny children access to routine health care that has been shown to dramatically reduce suicide and depression rates among (transgender and gender diverse) youth.”
The AAP has long been an advocate of access to transition medicine and surgery for youth, pointing to preliminary research that suggests it improves the mental health of trans children in the short term.
However, there are fears in the US and other countries that children with depression, eating disorders and other mental conditions, as well as autism spectrum disorder, are being rushed into transition without delving deeper into psychological symptoms that may be driving their feelings of childhood mismatch. could explain. their bodies and their sense of self.
There has also been a wave of ‘de-transitioners’ in several Western countries who have come to regret their choice to transition in their younger years because they believed doctors had failed them by not examining them as children. days, causing them to suffer from irreversible physical problems such as problems. going to the toilet or having sex.
Bev Jackson, co-founder of the UK LGB Alliance, a charity that supports gay, lesbian and bisexual people but opposes gender-affirming care, told DailyMail.com: ‘What concerns us most is that in the US it is red states versus being blue states.
“It has become a highly politicized issue, and the idea that every medical issue is being politicized is very alarming, because when you’re treating patients, you should only care about the scientific basis.”
Jackson added, “The worst part is that this is being presented as progressive. (If I were an American) I would be a Democrat. But on this point, Democrats are dead wrong.”
As the US has become increasingly divided over the issue, the British government last year halted all puberty blockers for children, saying more research is needed into their potential benefits and harms.
The move has not generated any significant reactions. It came after an explosive investigation into the Gender Identity Development Service (GIDS) at Tavistock, which found healthcare providers there were wrongly accelerating children to change genders – overlooking the mental health and social reasons behind their wishes .
Similar pauses have been imposed in Sweden, France, Finland and Norway.
Stephanie Davies-Arai, director of UK campaign group Transgender Trend, told DailyMail.com: ‘It is irresponsible for any health body to issue guidance on that basis. They cannot say with certainty that this approach is safe, but they still issue guidelines.
“We have to remember that this whole gender-affirming approach is not a clinically developed approach. The previous approach for children was to wait and provide therapeutic help. It’s case by case. And that approach never appeared to cause any damage. There were no risks with that approach.’
At least 22 Republican states have passed restrictions on gender-affirming care for children, with supporters claiming the goal is to protect children from irreversible medical interventions.
But blue states and cities have taken a hard line against these efforts, and trans rights have become a litmus test for American politicians seeking elections in the fall.
Ms Davies-Arai said: ‘Because it’s so politicized, if you question it you’re labeled transphobic. So it is not seen as a medical problem; it’s all political. When that happens, all medical ethics disappear.”
Unlike most European countries where universal health care is guaranteed through taxpayer dollars, the U.S. health care system is private and run primarily by insurance conglomerates such as Blue Cross, Blue Shield, and Elevance, which pass the costs on to patients.
If they don’t have insurance that requires a monthly premium, they will have to pay the entire bill themselves.
Not all insurance plans cover monthly puberty-blocking injections or hormone therapies, which can cost up to $1,200 each, making providing gender-affirming care very lucrative.
“There’s a lot of money to be made here in the U.S.,” Ms. Jackson said.
There is also evidence that children undergo the transition process and later regret it as they grow older.
The issue of transgender children’s access to health care has become a political lightning rod, deepening the divide between Democrats and Republicans
A transitioning woman (pictured left) who had a mastectomy at the age of 14 has criticized therapists who told her gender reassignment and surgery were the ‘only solution’ to her mental health problems
The young man, known only as Kobe, is pictured here on the left after deciding to stop transitioning and on the right after making the decision he now regrets
A Maryland woman named Cassie, who had a mastectomy at age 14, later said that therapists she met beforehand insisted the surgery was the “only solution” to her mental health problems — despite also struggling with a bipolar disorder, autism and sexual assault. trauma.
She also claimed that her doctor encouraged her to have the procedure done after just one visit and regretted the decision almost immediately after the surgery. She has branded it as ‘medical malpractice’ that professionals did not take more time to consider the long-term effects and possible consequences in advance.
Meanwhile, an American named Kobe, who started taking puberty blockers at age 13 and had his testicles removed at 19, said he bitterly regretted his decision to transition and that older transgender people told him to “play the suicide card ‘ to get treatment.
He now suffers from severe back pain which he fears could be osteoporosis, with puberty blockers linked to bone injuries.
There are signs that the US is slowing its efforts to make transition medicine available to young adolescents, just as Britain’s National Health Service did after a Tavistock Gender Clinic investigation found that children were being referred for medical treatment prematurely and in increasing numbers.
Vanderbilt University froze all gender-affirming care for children in 2022 after a specialist at the hospital was caught touting transition surgeries as “huge moneymakers” for their boss.
Between 2009 and 2019, the number of teens needing menopause treatment increased by 1,000 percent among biological males and 4,400 percent among females.
According to the Centers for Disease Control and Prevention, the number of young people in the US who identify as transgender has nearly doubled since 2017.
Ms Davies-Arai said: ‘A child is on the path to becoming a lifelong medical patient. Whether they continue or not, if they get off, you can’t just stop. You will still have to be monitored for life and have to figure out which hormones to take.”