A Joint Press Release from the AAP, AMA, APA, HHS, ACLU, HRC, Planned Parenthood, President Joe Biden, the DNC, and the UFT*

*Not really. But here's what they could say.

Photo by Alexander Grey on Unsplash

Note: I’ve been asking people the question: What do we need to do to get the Left to walk back their unpopular and dangerous stances on “gender-affirming care,” so that we can create true evidence-based policies in medicine, mental health, and education? Here I’m imagining what the various governmental and nonprofit organizations might announce if they acknowledged what Sweden, Finland, and the UK have: the reality of the ROGD cohort; the rise in detransitioners but lack of information about them; and the low-quality of the research on adolescent gender transition. If you have ideas for how the Left can embrace gender diversity but have a more evidence-based approach to regulating gender care, I’d love to hear yours in the comments.

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November 8, 2022

In light of emerging research and information, today we announce a Joint Task Force on Childhood and Adolescent Pediatric Gender Medicine. The bipartisan committee will be made up of people across the political, gender, geographic, cultural, and even political spectrum, and is committed to lifting the contentious issue of health care for children with gender distress out of politics, and viewing it as a health and safety issue.

Together we will:

1. Evaluate the science of pediatric and adolescent psychological and medical transition, employing a nonpartisan, systematic evidence review of available evidence.

2. Collect data from all clinics and companies which facilitate gender transition for young people, including freestanding and mail-order clinics.

3. Develop an accurate picture of the demand for these interventions, and the demographic makeup of those requesting it.

4. Design and implement long-term follow-up of every child psychologically and medically transitioned in this country since the first pediatric gender clinic opened in Boston in 2007.

5. Create new guidelines based on data and research, not politics or activism.

6. Implement clinical trials and high-quality research.

The move comes after the revelation that the cohort seeking social transition, puberty blockers, cross-sex hormones, and cosmetic gender surgeries like double mastectomies and orchiectomies is vastly different from the cohort on which these protocols are based. The Dutch, who pioneered these interventions, conducted research on children with life-long gender dysphoria, and screened out those with serious co-morbid conditions. They weren’t socially transitioned, and were evaluated over many years; if their dysphoria worsened at puberty, they would be considered for transition. We don’t yet have long-term data on this Dutch’s original cohort.

In the last decade, we have seen a spike in teen girls with no history of gender issues, coming out suddenly as transgender and demanding immediate medical intervention, as well as an increase in a similar population of boys. We recognize that this iteration of gender dysphoria, sometimes referred to as Rapid Onset Gender Dysphoria, while not an official diagnosis, must be studied in order to discern the proper treatment, because they are quite different from the population studied by the Dutch, and on whom the protocol is based. We have learned from parent and patient testimony, along with whistleblowing therapists, that in contrast to the way young people are rigorously evaluated under the Dutch model, many of them are receiving little evaluation before being sent down the medical path.

Meanwhile, we have seen a growth in detransitioners, and others who feel that gender transition was the wrong treatment. Many of us were under the impression that detransition was rare, and often heard quoted a 1 to 2 percent detransition rate. We now understand that, without long-term follow-up, it is impossible to determine the actual rate, but recent research shows that even after a short time, 7% of patients might detransition.

We also recognize that social transition is a serious psychological intervention, and recent research indicates that the practice can greatly increase the chances of medicalization, which were previously low. We have learned the schools are not only facilitating these interventions without informing parents, but that many school guidelines insist that parents be kept in the dark about their children’s psychological health. Some parents have been investigated by Child and Protective Services for not facilitating psychological or medical transition. Still others have been investigated for facilitating gender transition. We recognize that it is the duty of educational, medical, and psychological professionals to support families, not to create disruptions within them, and CPS has no role in how a family responds to a child with gender issues. Thus, we will be further studying social transition and school policy.

We have learned that Finland, Sweden, England, and the state of Florida have conducted systematic evidence reviews, which evaluate not only the findings of research but the quality of that research, and deemed it low or very low quality. This means that the findings are unreliable, likely to be inaccurate and at high risk of bias. We recognize the lack of quality research around fertility and sexual function, and the likelihood that the gender affirming protocol of puberty blockers followed by cross-sex hormones may impair both. We also acknowledge that the research on suicidality and gender identity has been grossly misrepresented by both the media and the medical community, and that research does not show pediatric and adolescent gender medical interventions prevent suicide. More and better research is needed.

Finally, we recognize that some boosters and providers of gender-affirming care—or pediatric and adolescent psychological and adolescent sex changes—have pressured parents and children, based on these misinterpretations of research. Many patients are reporting that they were not informed about medical and surgical outcomes like entering into menopause, vaginal atrophy, fistulas, and constant pain, among many other issues. We understand the need for clearer language around sex and gender, and for transparency in terms of what we do and do not know.

America is built on diversity, and we recognize that gender diversity is normal and natural. We hope that someday our society understands that gender differences among children—how masculine or feminine a young person is, regardless of biological sex—are acceptable and unremarkable, neither to be stigmatized nor in and of themselves requiring medical or psychological interventions. In the meantime, we understand that cost-benefit analyses are required to create sound policy, and that we must gather all the data on costs and benefits, crossing party and ideological lines, and relying on good science and faith that families want what’s best for their children.

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