We vigorously object to the normalization of childhood gender identity disorder (GID) promoted by the American Academy of Pediatrics (AAP) in the article “Psychological and Medical Care of Gender Nonconforming Youth,”1 published in the December issue of Pediatrics. The recommendations of the authors to reinforce the delusions of gender identity–confused children, and to prescribe puberty-blocking hormones as though puberty were a disorder, are outrageous. This approach violates the oath physicians take to “do no harm.”
Although some affected children and their parents may report being happier when health professionals, families, friends, and schools affirm their false beliefs, “happiness” is not always consistent with good health. It can also be short-lived.
A recent 30-year study in transgendered adults in Sweden, unquestionably a transgender-affirming culture, should give the AAP and American Psychiatric Association (APA) pause: it showed that individuals who underwent sex reassignment surgery suffered significantly greater morbidity and mortality when compared with matched controls. Shockingly, their suicide mortality rose almost 20-fold above the comparable nontransgender population. The authors concluded, “Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism . . . [emphasis added].”2
There is no adequate body of research on the long-term use of puberty blockers in early adolescence followed by lifelong administration of exogenous testosterone to biological girls or of exogenous estrogen to biological boys. However, there is significant evidence indicating stunted growth and infertility from puberty-blocking hormones, and possible malignancies from chronic use of synthetic hormones.3 Yet, this is what the AAP and APA recommend.
We submit that children who dread the development of secondary sex characteristics are emotionally troubled; puberty is not a disease. In fact, puberty brings relief for the vast majority of children receiving therapy for GID, because hormone surges propel the development of their brains as well as their bodies and they come to identify with their biological sex.4,5 Science and ethics trump the current recommendations of the AAP and APA, which amount to conducting an ideology-driven social experiment on vulnerable children and their families. All physicians must work for the reinstatement of the diagnosis and sound treatment of childhood GID.
Conflict of Interest: None declared
- Vance SR Jr,
- Ehrensaft D,
- Rosenthal SM
- Vigil P,
- Orellana R,
- Cortes M,
- et al
- Copyright © 2015 by the American Academy of Pediatrics