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AAP ‘silencing debate’ on gender dysphoria, says doctor group


 

The American Academy of Pediatrics (AAP) is at the center of a row with an international group of doctors who question whether hormone treatment is the most appropriate way to treat adolescents with gender dysphoria.

After initially accepting the application and payment from the Society for Evidence-Based Gender Medicine (SEGM) for the organization to have an information booth at the AAP annual meeting in October, the AAP did a U-turn earlier this month and canceled the registration, with no explanation as to why.

“Just days earlier,” says SEGM in a statement on its website, “over 80% of AAP members” had indicated they wanted more discussion on the topic of “addressing alternatives to the use of hormone therapies for gender dysphoric youth.”

“This rejection sends a strong signal that the AAP does not want to see any debate on what constitutes evidence-based care for gender-diverse youth,” they add.

Asked for an explanation as to why it accepted but later rescinded SEGM’s application for a booth, the AAP has given no response to date.

A Wall Street Journal article on the furor, published last week, has clocked up 785 comments to date.

There has been an exponential increase in the number of adolescents who identify as transgender – reporting discomfort with their birth sex – in Western countries, and the debate has been covered in detail, having intensified worldwide in the last 12 months, regarding how best to treat youth with gender dysphoria.

Although “affirmative” medical care, defined as treatment with puberty blockers and cross-sex hormones to transition to the opposite sex, is supported by the AAP and other medical organizations, there is growing concern among many doctors and other health care professionals as to whether this is, in fact, the best way to proceed, given that there are a number of irreversible changes associated with treatment. There is also a growing number of “detransitioners” – mostly young people who transitioned and then changed their minds, and “detransitioned” back to their birth sex.

“Because of the low quality of the available evidence and the marked change in the presentation of gender dysphoria in youth in the last several years (many more adolescents with recently emerging transgender identities and significant mental health comorbidities are presenting for care), what constitutes good health care for this patient group is far from clear,” notes SEGM.

“Quelling the debate will not help America’s pediatricians guide patients and their families based on best available evidence. The politicization of the field of gender medicine must end, if we care about gender-variant youth and their long-term health,” they conclude.

A version of this article first appeared on Medscape.com.

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