Much of America has turned a blind eye to how medical institutions in European nations have shifted away from transgender procedures, according to doctors who are critical of the U.S. model.
Dr. Julia Mason, a member of the American Academy of Pediatrics (AAP), told The Epoch Times that the push in the United States for transgender medical interventions on minors is “primarily political” and linked to profit-making.
“The United States is becoming more of an outlier every day,” Dr. Mason said. “Every country that has taken a serious look at the evidence has concluded that medical transition of children is experimental, and the evidence doesn’t support doing it.”
In his remarks at the White House on June 8, President Biden condemned attempts to ban sex-change surgeries and transgender medical interventions on children, calling such proposed legislation “cruel and callous.”
The Political Divide
In the United States, pushback from detransitioners and conservative, religious, and parental rights groups against gender ideology has triggered protests organized by trans activists, including far-left Antifa militants.Transgenderism, Dr. Mason said, has become “a political tribal marker” and a “wedge issue.”
“I’m a Democrat,” she said. “California is one of the most Democratic states, and being pro-transition, pro-transgender, pro-pediatric transition is a Democratic tribal marker, and so California is just leading the way on that topic for that reason.”
Many people are treating the “gender-affirming” model as though it were settled medical science, she said.
“We’re far from settled science, and it’s just getting more unsettled,” Dr. Mason said, noting that a paper she wrote, “Far from Settled Science: a Call for Caution in the Care of Gender Dysphoric Youth,” was rejected by the Journal of Pediatrics about three years ago.
Dr. Mason, who practices medicine in Oregon, has also drafted a resolution calling on the AAP to align its treatment recommendations for gender dysphoria with findings from systematic reviews of evidence. It states that as of February 2023, “there is no evidence that the AAP plans to conduct a systematic review of evidence related to gender dysphoria treatments, pursuant to the AAP’s Statements, Technological Supports and Manuals in Progress on its Section on LGBT Health and Wellness.”
Although nearly two dozen AAP fellows signed the resolution, Dr. Mason couldn’t find anyone in the organization’s leadership to co-sponsor it so that it could be put to a vote.
Dr. Mason is also an adviser to Genspect, an international alliance of professionals, transgender people, detransitioners, parent groups and others that offers an alternative to the World Professional Association for Transgender Health (WPATH) standards of care, and a board member of the Society for Evidence-Based Gender Medicine, which promotes “ethical and evidence-informed healthcare” for children and young adults with gender dysphoria and opposes all transgender medical interventions on anyone under the age of 25.
She said that while mature adults can make their own decisions, she worries about vulnerable adults, especially those with undiagnosed autism, making life-altering decisions to transition.
“I don’t want to block all transition. I just think people should be made aware of what’s going on,” she said.
Rep. Crenshaw called the interventions on minors a “human rights atrocity ... within the very institutions that should know better,” in a June 9 statement.
“In a place where ‘do no harm’ is the ultimate guiding principle, there is no excuse to ever perform these treatments that permanently alter a child’s physiology,” he said. “From now on, we will not allow a dime of this taxpayer-funded program to go toward children’s hospitals that cater to the harmful pseudoscience that is ‘gender-affirming care.’”
“We keep hearing this is a politicized issue, this is manufacturing a culture war,” Rep. Crenshaw said. “I’ve got to say, we aren’t the ones who did that. We aren’t the ones that came up with this radical new movement that is performing permanent physiological changes to children with no evidence of any benefits. We didn’t start that. We’re just trying to stop it, because it’s crazy.”
He asked McNamara why there haven’t been systematic reviews of “gender-affirming care,” considering that the British Journal of Medicine looked at 61 systematic reviews and concluded “there is great uncertainty about the effects of puberty blockers, cross-sex hormones and surgeries in young people.”
When Crenshaw asked Dr. McNamara to name a study that can show strong evidence of the benefits of “gender-affirming” therapies, she didn’t identify one, instead deferring to “standards of care” and the “quality evidence grading system.”
Rep. Crenshaw said taxpayer money shouldn’t be used to pay for “gender-affirming care” for minors when nearly 70 percent of Americans oppose it.
AMA Position
Earlier this month, the American Medical Association (AMA) passed an Endocrine Society resolution reaffirming its commitment “to protect access to evidence-based ‘gender-affirming care’ for transgender and gender-diverse individuals.”The resolution was co-sponsored by the AAP among other organizations and suggested that policies and legislation that contradict the “gender-affirming” model “do not reflect the research landscape.”
“Due to widespread misinformation about medical care for transgender and gender-diverse teens, 18 states have passed laws or instituted policies banning ‘gender-affirming care,’” the society said in a statement. “These policies do not reflect the research landscape. More than 2,000 scientific studies have examined aspects of ‘gender-affirming care’ since 1975.”
“As political attacks on ‘gender-affirming care’ escalate, it is the responsibility of the medical community to speak out in support of evidence-based care. Medical decisions should be made by patients, their relatives, and health care providers, not politicians,” the statement reads.
The AMA stated that it’s opposed to any criminal and legal penalties against patients seeking “gender-affirming care,” family members or guardians who support them in seeking such care, and health care facilities and clinicians who provide such care. Additionally, it will work with federal and state legislators to oppose such policies and collaborate with other organizations “to educate the Federation of State Medical Boards about the importance of ‘gender-affirming care.’”
The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Urological Association, the American Society for Reproductive Medicine, the American College of Physicians, the American Association of Clinical Endocrinology, GLMA: Health Professionals Advancing LGBTQ+ Equality, and AMA’s Medical Student Section co-sponsored the resolution.
WPATH Influence
Dr. Michael Laidlaw, a California-based endocrinologist who works with adults, said medical organizations in the United States, including the Endocrine Society and AMA, are “completely under the influence of the advocacy organization WPATH.”Dr. Laidlaw said in an email to The Epoch Times that these organizations “show no ability for independent thought” with respect to the treatment of child and adolescent gender dysphoria.
“In contrast, institutions like [National Health Service] England in their recent guidance do not appear to reference WPATH at all and instead recommend psychosocial and psychological support and interventions,” he said.
“WPATH pushes kids down the path of harmful social transition, puberty blockers, hormones, and surgeries even though the majority would have desisted by adulthood if not put on that pathway,” he said. “Unfortunately, our American medical organizations care more about being politically correct than looking out for what’s best for kids.”
‘Should Be Illegal’
Dr. Jeff Barke, a primary care physician in California’s Orange County and member of the Association of American Physicians and Surgeons, told The Epoch Times that the recent surge in support for the transgender movement is political and contrived.“It’s not science. It is politics,” he said. “Europe is moving toward freedom ... while we are headed toward more socialism and totalitarianism.”
Dr. Barke said that performing gender transition surgery on minors is a “grotesque” form of child abuse that “should be illegal.”
He suggested that euphemisms such as “top surgery” and “bottom surgery” were created to normalize these surgeries to make them seem benign and less harmful and invasive.
Just as no surgeon would remove a healthy arm because a patient requested it, neither should they remove healthy breasts or genitals, he said.
He scoffed at the notion that “gender-affirming care” is settled science.
“‘Gender-affirming care’ and the move towards that is new. This is not settled science. If it was settled science, where was it 100 years ago?” he said. “There is no such thing as settled science.”
Science, by definition, is experimentation, argument, debate, and discovery, Dr. Barke said.
He said that given the high rates of depression, anxiety, and suicide among transgender people, gender dysphoria should be treated as a mental health issue—and “not just simply affirming” patients and using hormones and surgery to “permanently dismantle” and “disfigure” them.
AAP ‘Doubling Down’
Another physician and AAP member, who goes by the pseudonym Dr. Grace Clark for fear of retaliation, told The Epoch Times she is deeply concerned about the “shocking and abysmal lack of interest” among the United States’ medical societies to review “gender-affirming” policies.Dr. Clark said the AAP seems to be “doubling down” on “gender-affirming care” and that people who dissent from such policies have no recourse but legislation or the courts.
“That’s not where these kinds of things should be decided,” she said. “That’s a really heavy-handed way of figuring out the best medical way forward, but the American Academy of Pediatrics has been so unwilling to entertain a broader point of view.”
From a medical standpoint, Dr. Clark said she agrees with Republican views against the use of puberty blockers and cross-sex hormones for gender dysphoric children but recommends focusing on the children instead of political goals.
“It’s become really political rather than medical,” she said. “Now, it seems like people on both sides are trying to score points. So, they’re trying to use this topic for their benefit without actually thinking about what’s good for kids.”
Both Dr. Mason and Dr. Clark said that because many European countries have nationalized health care, they have a fiduciary responsibility to spend the public’s dollars wisely on medical programs that are evidence-based and subject to systematic reviews.
But in the United States, where health care is more profit-driven, it’s different, Dr. Mason said.
Government-run medicine, however, also has its downsides, she said.
“People are interpreting Obamacare to mean ... that you have to cover ‘gender-affirming care,’” Dr. Mason said. “I don’t know if that’s true, but that’s what everyone’s running with.”
The report, released on Jan. 16, was conducted by Do No Harm, a group that seeks to remove “radical, diverse, and discriminatory ideology,” from the health care profession.
