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

Transgender Medicine: Europe & America Part Ways

A recent article by Leor Sapir explores the diverging paths taken by Europe and America in the realm of transgender medicine for youth. Europe is veering towards a more cautious approach, prioritizing psychotherapy and reserving hormonal interventions for extreme cases. This stands in stark contrast to the American model, which advocates for early affirmation of a patient’s gender identity, often through hormonal treatments and, in some cases, surgeries.

The crux of the disagreement lies in the application of evidence-based medicine (EBM). European health authorities, guided by EBM principles, are making decisions based on systematic reviews of the best available research. These reviews have highlighted significant gaps in the evidence supporting sex modification in minors. In contrast, American medical associations, while claiming their treatments are “medically necessary” and “life-saving,” often rely on studies that EBM experts consider flawed or of low quality.

Sapir’s article further criticizes the American approach for its lack of comprehensive mental health assessments and differential diagnosis in pediatric gender clinics. It suggests that the U.S. healthcare system’s susceptibility to profit motives, activist doctors, and political pressures may be contributing to this divergence from European practices.

We are medicalizing gender diversity in children without sufficient evidence-based backing. Sapir calls for a more cautious, evidence-based approach, akin to the one adopted by many European countries.


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