The American Academy of Pediatrics Orders A Scientific Review of Current Gender-Care Practices

But will it be an honest review? Leor Sapir has written an opinion piece in the Wall Street Journal asking some important questions. Along with his usually brilliant observations.

The piece is behind the normal WSJ paywall, so here are the highlights.

According to Sapir, the AAP is essentially a trade union. Given its vested interests as a trade union, which understandably prioritizes its members, i.e. the same doctors who have performed gender-affirming care, will this be an impartial review? Or will this be an example of confirmation bias, and/or simple CYA?

The AAP has consistently advocated for the safety and effectiveness of sex-trait modification, influencing various stakeholders from insurance companies to the Biden administration.

The AAP and prominent members have consistently assured policy makers and judges that sex-trait modification is safe and effective and based on strong science. Insurance companies have based their coverage decisions on these claims. Democrats have used them to cast opponents as bigots. The Biden administration regularly cites the AAP in its efforts to guarantee minors unfettered access to hormonal drugs and life-altering surgery. Parents have accepted AAP claims and agreed to allow doctors to disrupt their children’s natural puberty, flood their bodies with synthetic hormones, and amputate their healthy breasts. 

Yet existing systematic reviews from European health authorities have found weak evidence supporting the use of puberty blockers and cross-sex hormones.

Given these findings, Sapir suggests the AAP should advise extreme caution in using these interventions for youth gender dysphoria, as other countries have done, while its own review is ongoing. (Reviews typically take 12 to 18 months)

Unlike narrative literature reviews, systematic reviews follow a transparent, reproducible methodology on the same body of research. Anyone who uses the same methodology should arrive at more or less the same result. The existing systematic reviews on the benefits and risks of puberty blockers and cross-sex hormones, conducted by health authorities in three European countries, all found “very low” quality evidence for these interventions. 

Given the finding of every existing systematic review to date that the evidence for “gender-affirming care” is exceptionally weak, the AAP should immediately recommend extreme caution in the use of puberty blockers, cross-sex hormones and surgeries in treating youth gender dysphoria. This is a no-brainer; health authorities in the U.K., Norway, Sweden, Finland and France have done it. “There is not enough evidence to support the safety, clinical effectiveness and cost effectiveness to make the treatment routinely available at this time,” said the statement from England’s National Health Service.

Source: Wall Street Journal [emphasis mine]

We’ll be watching.


Protect Children

European Nations Adopt A More Cautious Approach Toward Gender Dysphoria

Much of Europe is moving away from Gender-Affirming Care.

Read all about it in Forbes….

…longitudinal data collected and analyzed by public health authorities in Finland, Sweden, the Netherlands, and England have concluded that the risk-benefit ratio of youth gender transition ranges from unknown to unfavorable.

The landscape of gender-affirming medical procedures is undergoing significant transformations in Europe. Nations are progressively adopting a more guarded stance concerning providing gender-affirming medical treatments to minors; evidenced by a wave of regulatory shifts and newly-introduced legislations.

Notably, the UK has led the charge with a pivotal court ruling, dubbed the ‘Bell ruling,’ which underscores the improbability of minors under 16 providing informed consent for undergoing puberty blockers. This judgment reverberated across Europe, leading Sweden and Finland to usher in stricter guidelines regarding gender-affirming healthcare for young people.

…according to European health authorities and medical experts, there isn’t yet a medical consensus for the use of pharmaceutical and surgical interventions in gender dysphoric minors.

Finland, in particular, now necessitates that minors seeking such treatments should be subject to a comprehensive mental health evaluation before commencing treatment. Likewise, Sweden decrees that puberty blockers and cross-sex hormones should not be the go-to treatment modality for gender dysphoria among children and adolescents.

Proponents of this cautious approach claim that such regulations ensure careful consideration, protecting minors from potential regret or adverse health impacts.

Forbes continues…

A common claim by Americans who oppose state restrictions on gender-affirming care for minors is that Sweden, Finland, the Netherlands, and the U.K. have not done away with hormonal interventions, and therefore lawmakers who seek limits are presumably going against what European health authorities recommend. Additionally, voices in America’s “affirmative-medicine” movement point to Europe not having bans on gender-affirming care for minors. It’s true that Europeans aren’t banning such care, and so legislators in the U.S. who pursue bans are at odds with European recommendations. But this only tells part of an evolving and layered story.

At the risk of overgeneralizing, the American approach provides more autonomy to minors, in which the medical establishment’s role is mostly to affirm a child’s declaration that he or she is trans. This affirmative model immediately removes several of the guardrails put in place by, say, the Dutch Protocol, resulting in a possible deficient lack of medical “safeguarding.”

A growing number of nations in Europe are not practicing “gender-affirming care” for minors in quite the same way as America is. In fact, for several years, Europe has been moving in a different direction from the U.S., as Europeans exercise greater restraint when treating children with gender dysphoria. In essence, progressively the message emanating from European gender experts is that until there is reliable long-term evidence that the benefits of youth gender transition outweigh the risks, it is prudent to limit most medical interventions to rigorous clinical research settings.

SOURCE: Forbes

Companion Post


Love Refuses To Affirm Confusion.

White Robes Not Enough

“Governments are called upon to protect citizens from harmful practices in all other industries; we don’t carve out exceptions for a profession just because its members wear white robes.”

Leor Sapir responds to a gender-affirming pediatrician and dad who derides recent legislative restrictions on pediatric sex changes.

Click Tweet to read full response.

Where does “burden of proof” lie? See excellent comment below.