The Association of American Physicians and Surgeons (AAPS) is warning about “unknown and unknowable long-term risks” it says are inherent to “gender-affirming care” in minors, adding that the consequences of gender transition surgery are irreversible.
“Gender-affirming” procedures include so-called puberty blockers, sex hormones, and surgery, such as castration, penectomy, and mastectomy, the nonpartisan professional association noted in its Feb. 20 official statement outlining its stance on “gender-affirming care” for children.
The AAPS warns that gender transition procedures are “generally irreversible and have a high probability of causing sterilization.” The procedures also “commit a patient to a lifelong need for medical, surgical, and psychological care.”
Such procedures in minors also are medically and ethically contraindicated due to a lack of informed consent, the AAPS stated.
“Physicians and medical professionals should refuse to be mandated or coerced to participate in procedures to which they have ethical or scientific objections or which they believe would harm a patient.”
Founded in 1943, the organization represents doctors in all specialties nationwide and seeks to preserve the practice of private medicine. Over the years, the group has been a strong proponent of patient autonomy and freedom of discourse in medicine.
Biological Sex Can’t Be Changed: AAPS
The association maintains that while medical, surgical, and other methods can be used to alter the physical appearance of a person’s body, they can’t change a person’s biological sex.
Biological sex is determined at conception by genotype, and with the exception of rare circumstances that could result in ambiguous genitalia, biological sex is “indeed obvious” and is correctly identified at birth, the AAPS states.
Biological sex, or genotype, then determines the role of a person in reproduction.
“Reproduction requires a male gamete (sperm), which can only be produced by a person of XY genotype, and a female gamete (egg), which can only be produced by a person of XX genotype,” the group states. “Primordial germ cells are present at birth.”
In recent months, some states have attempted to curtail or outlaw gender-related procedures for minors, while others are seeking to ensure access to gender-altering hormones and surgeries.
The governor of Mississippi said on Feb. 21 he will sign a ban on “gender-affirming care” that’s been approved by state lawmakers, joining governors in Utah and South Dakota. Meanwhile, judges have temporarily blocked similar laws in Arkansas and Alabama.
Gender Fluidity Is ‘Controversial’: AAPS
The group states, “The construct of gender fluidity in the current cultural discourse is controversial.”
“There has been an explosive increase in persons who identify with the construct of gender different from sex, at an age where identity is easily malleable and brain development is not fully concluded,” part of the AAPS statement reads.
“Conflicting motivations have led to a growing industry dedicated to providing ‘gender-affirming’ procedures,” the statement reads.
Separately, the American Medical Association and the American Academy of Pediatrics (AAP) have in recent years issued statements in support of “gender-affirming care.”
Both groups assert that gender transition procedures can improve a gender dysphoric person’s mental health and result in lower rates of suicide, and that forgoing such care puts the patient at higher risk of anxiety, stress, substance abuse, and suicide.
But the groups’ statements don’t acknowledge that some gender transition procedures render the individual highly unlikely to be able to reproduce or make other changes that are irreversible.
Advocacy Group Pushes for Safe Health Care
The AAPS’s public statement comes two days after an advocacy group for people with gender dysphoria issued an open letter directed at more than 30 medical organizations, asking them to ensure health care that’s free of influence from politics and activists who shut down those who seek to research gender dysphoria.
“For the safety and well-being of all trans and gender dysphoric people, we need our healthcare, especially our mental healthcare, disentangled from a well-meaning yet misappropriated academic philosophy,” the Gender Dysphoria Alliance (GDA) said in its letter.
Founded in 2021, GDA includes researchers, mental health professionals, and laypersons, some of whom are transgender. The group also includes people who have disavowed their former transgender identity.
“As people living with Gender Dysphoria, we want competent, evidence-based care. This includes mental health care and thorough psychosocial assessment prior to any medicalization, at any age,” the group says in their letter.
“What we are advocating for is not conversion therapy, despite what many trans activists often claim. According to the evolving standard for treating Gender Dysphoria, anything other than immediate access to hormone therapy and surgeries is misconstrued as conversion therapy,” the group added. “This is not only an absurd view of psychosocial evaluations, it’s causing unnecessary harm to young, vulnerable people.”
Conversion therapy is a term used to refer to efforts to prevent people from identifying as transgender or to prevent them from expressing outwardly as their opposite biological sex.
Janice Hisle and The Associated Press contributed to this report.