Pediatricians across America are at war with their own professional body over controversial puberty-blocking drugs routinely handed to teens wanting to change gender, DailyMail.com can reveal.
The top child health experts accuse the American Academy of Pediatrics (AAP) of pushing the ‘harmful’ drugs on transgender-identifying youngsters, according to damning leaked documents.
Disturbingly, the documents also reveal experts believe the APP is deliberately silencing internal criticism by blocking moves for a crucial policy review.
The papers, leaked by a whistleblower, expose how rank-and-file AAP members across the U.S. are slamming the academy’s ‘shoddy’ drugs-and-hormones-first approach to trans-identifying teens.
They insist many would benefit from counselling or therapy instead — and urge the professional body to follow a more cautious approach currently being adopted by similar bodies in other countries.
Fast-tracking adolescents into powerful drug cocktails takes a huge toll on young bodies and can lead to sterility and osteoporosis, critics say. For many teens, transitioning is celebrated, but others regret the treatment and seek reversals.
The AAP says its guidelines — to reinforce the gender a youth selects, including through drugs, cross-sex hormones and eventually surgery — are evidence-based and that it is open to ‘collaborative conversations’ on policy.
But angry AAP members say the academy changed its rules to block a member-drafted resolution to launch a policy review. It led to the review being sidelined at the academy’s leadership conference, which ended in Chicago on Monday.
Instead, members took the unusual step of airing their concerns in the comments section for a separate resolution in the AAP’s members-only website.
In the comments, leaked to DailyMail.com, AAP members said the academy was ‘endorsing great harm’, that its care package for trans-identifying teens was based on ‘scant and shoddy’ evidence and that dolling out drugs and hormones was ‘unsafe and unsustainable’.
‘Before promulgating gender-affirming care, with all of its ethical implications (irreversible bodily changes, sterility, etc.) … don’t we want to be sure this is the best path?’ wrote one anxious pediatrician.
The Damning Documents
A whistleblower leaked files to DailyMail.com showing dozens of pediatricians bashing their own professional body, the American Academy of Pediatrics, for a policy of dolling out puberty blockers without properly assessing patients. Names and identifying details have been redacted to avoid online harassment of the commenters
Another member said there was ‘no good long-term outcome data’ for those who undergo the arduous physical process of transitioning, and pointed to the 37,000 members of an online forum for regretful ‘de-transitioners’, as they are known.
‘What is most needed right now is better research to make sure we do the right thing for our patients,’ wrote the pediatrician, who, like others, we are not identifying, as such views have led to online harassment in the past.
Others bashed the AAP for stonewalling Resolution 27, in which five members called for a ‘rigorous systematic review’ of the academy’s 2018 gender-affirming policy, saying growing numbers of transitioners regret their treatment and seek reversals.
One AAP member complained they were ‘unable to comment’ on the document; another said they ‘no longer trust the AAP’ as the resolution was ‘removed’ and ‘debate on the matter was silenced egregiously’.
‘There is NO open dialogue on these medical treatments by the AAP,’ posted another.
‘Input from the membership MUST occur.’
Members posted their concerns from New York, Alabama, Kentucky, Virginia, Idaho, Nevada, Wisconsin, Colorado, California, Utah, Texas, Tennessee, Maine, South Carolina, North Carolina, Nevada and Pennsylvania.
Resolution 27: The motion that questioned AAP’s gender affirmation policy
Five pediatricians in March issued a resolution calling for a ‘rigorous systematic review’ of the AAP’s 2018 gender affirmation policy, warning of growing numbers of transitioners who come to regret their treatment and seek a reversal.
The paper describes ever-more clinicians and parents of trans-identifying youth now ‘expressing deep concerns about the use of medical and surgical interventions without sufficient exploratory psychotherapy’.
Like policy rethinks in Britain, Finland and other European nations, the review should cover the ‘safety, efficacy, and risks of childhood social transition, puberty blockers, cross sex hormones and surgery’, it says.
Resolution 27 did not advance at the leadership meeting in Chicago. It was the only resolution affected by new procedural rules introduced by the academy earlier in the year. The AAP says it changed the rules before it saw the troublesome resolution
The academy has some 67,000 members. Five members wrote Resolution 27, dozens posted critical comments online, but it is unclear how many question the academy’s policy to affirm the choice of trans-identifying youngsters.
Julia Mason, an Oregon-based pediatrician and one of five authors of Resolution 27, said ever-more colleagues across the U.S. wanted to ‘slow down’ the mass handout of puberty-blockers and spend more time evaluating trans-identifying teens.
‘I’m really disappointed the AAP is being driven by ideology, rather than evidence,’ Mason, also an advisor for the Society for Evidence-based Gender Medicine, told DailyMail.com.
‘They’re embarrassed that they’ve let young activist doctors get them on record in support of gender-affirming care, and now they can’t backtrack. They’ve suppressed my efforts and come up with new rules to hide what we’re trying to say from rank and file pediatricians.’
Several members said the U.S. should be guided by policy shifts in Europe, where health chiefs in several countries have backtracked after carrying out their own policy reviews.
Britain’s health service recently decided to close the country’s only gender identity clinic for children, after a damning review and a slew of allegations by former staff and patients about rushing young people onto treatment.
A major Swedish clinic last year stopped giving puberty blockers and hormones to children, and Finland’s health chiefs decided that psychotherapy, not drugs and hormones, should be the first-line treatment for gender-dysphoric youngsters.
Julia Mason, an Oregon-based pediatrician (pictured) criticizes the AAP leadership for its ‘drugs-first’ policy for transgender youth, and for blocking calls for a review
AAP leadership (some of whom are in this undated promotional file image, above) are under fire for pushing the ‘harmful’ drugs on transgender-identifying youngsters. The AAP says its guidelines — to reinforce the gender a youth selects, including through drugs, cross-sex hormones and eventually surgery — are evidence-based and that it is open to ‘collaborative conversations’ on policy
A Reddit forum for trans people who regret transitioning and seek to reverse treatments has clocked up 37,000 members. They share their experiences about taking cross-sex hormones, puberty blockers and other issues
Parents have complained about being sidelined as their children make rash decisions about changing gender, which are reinforced by clinicians who follow AAP guidelines and provide drugs to those as young as 13.
Last month, California teenager Chloe Cole spoke out against the rush to affirm youngsters with drugs and hormones.
She told a medical panel how she was encouraged as a 13-year-old to take puberty blockers and later have surgery that ‘irreversibly and painfully’ damaged her body as she transitioned to Leo, a boy.
In her testimony, she warned of the dangers of online LGBTQ+ activism, unreliable therapists and a medical process and its reversal that left her unlikely to be able to have children and unable to breastfeed.
Chloe Cole says her short-lived transition to being a boy, Leo, was a mistake, and that years of treatment from age 13 onwards and the later reversal took a huge toll on her body
Alia Ismail, 27, from Michigan, US, pictured right, is beginning the process of de-transitioning back to female after realizing that her new male identity, pictured left, did not represent who she was
Likewise, Alia Ismail, 27, from Michigan, has told of how she underwent a medical transition involving hormones and a double mastectomy to become Issa, but then switched back as she was unhappy with the new identity.
Resolution 27 did not advance at the leadership meeting in Chicago. It was the only one out of 45 such resolutions that was affected by new procedural rules introduced by the academy earlier in the year.
The AAP says it changed the rules before it saw the troublesome resolution.
The academy’s advice guides the work of some 67,000 members and the gender-affirming policies of President Joe Biden’s administration. Its policy echoes the World Professional Association for Transgender Health and other bodies.
The AAP says there is strong consensus support for its transgender care model, which includes repeated psychological evaluations of patients, involves their parents and does not always lead to cross-sex hormones or surgery.
Resolution 27 did not make the cut at last weekend’s meeting, but a separate resolution on ‘increasing education, resources and training to pediatricians’ on transgender care was being assessed by the board of directors, the AAP said.
‘AAP supports the ongoing evaluation of evidence around the care of transgender young people,’ the academy said in a statement to DailyMail.com.
Various parts of the academy ‘are engaged in numerous collaborative conversations about transgender care, and we expect those discussions to continue’, it added.
While transgender issues have been politically divisive in Britain, they have gained special significance in the U.S. and frequently feature in ferocious ‘culture war’ rows between liberals and conservatives.
Republicans have passed several bills this year directed at transgender youth, including measures to stop classroom debates on gender identity, restrict participation in sports and blocking access to drugs for transitioning.
Laws in Arizona, Texas and Alabama are aimed at stopping doctors from performing gender-reassignment surgery or deterring parents from providing gender-affirming care to their transgender children. Some face legal challenges.
Polls show Americans are divided, but hew to traditional gender norms.
A Pew Research Center poll in May found that most Americans — 60 percent — said sex was determined at birth, rather than by an individual’s choice, while 46 percent favored laws against providing children with medical care to transition.
An NPR/Ipsos survey the following month found that 31 percent of respondents supported state laws preventing transgender youngsters from undergoing medical transitions, while 47 percent opposed them.
Pictured: The AAP headquarters, in Itasca, Illinois. The academy has 67,000 members, but it remains unclear how many of them support its policy to affirm the choice of trans-identifying youngsters