Medical Gender Transition in Children – American Academy of Pediatrics Headquarters vs. the World

Courtesy American Academy of Pediatrics

by James C. Sherlock

Who cares for transgender kids the most and is looking out for their best interests?

  • The American Academy of Pediatrics (AAP) headquarters leadership; or
  • Dissenting AAP members and the medical societies of some of the leading nations in the science of medicine?

A reasonable and important question, since Virginia and the rest of the nation need to know what is best for kids before we squabble about who chooses.

An op-ed in The Wall Street Journal by pediatrician Dr. Julia Mason and Leor Sapir, a fellow at the Manhattan Institute, pulled back the curtain on the politicization of AAP headquarters and its suppression of debate on matters of medical treatment of children diagnosed with gender dysphoria.

They take on the efforts by AAP to suppress:

  • both public knowledge of the gaps in the science of child transgender medicine; and
  • efforts in conservative states to regulate on-demand puberty blockers, cross-sex hormones and surgery in children.

Importantly, they revealed that Sweden, Finland and the U.K. have enacted restrictions on medical transition of minors and that medical societies in France, Belgium and Australia are on the verge of doing so.

What do the medical societies and government health services in those countries know that the AAP does not permit discussion of and its scriveners in the American press have not reported?

To quote the WSJ op-ed:

A spate of headlines this month declared that America’s surge in transgender identification wasn’t being caused by a social contagion. These articles were prompted by a new study by Jack Turban and colleagues in Pediatrics, flagship journal of the American Academy of Pediatrics. The study claimed that social influence isn’t the reason that as many as 9% of America’s youth now call themselves transgender.

The authors call the headline-grabbing study:

…deeply flawed and likely couldn’t have survived a reasonable peer-review process. The swift response from the scientific community made both points clear—with even those who support hormones and surgery for gender-dysphoric youth noting that Dr. Turban’s shoddy science undermined their cause.

A low-stakes faculty lounge spat? Not really.

…the media have promoted his work as a refutation of the claim that the wildfire spread of transgender identity is an example of social contagion—a phenomenon in which members of a group (mostly young and female) mutually influence one another’s emotions and behavior.

Not social contagion?

Dr. Turban has not publicly rejected the theory that the epidemic is the result of a Chinese virus. (This is true, but it is also true that there is no such theory, so he was not asked about one. See how that works?)

Turban, a psychiatrist, has a distinguished academic CV and is a media darling. He is a member of the media committee of The American Academy of Child & Adolescent Psychiatry and the communications council of the American Psychiatric Association.

He is an incoming Assistant Professor of Child & Adolescent Psychiatry at the University of California, San Francisco. The same UCSF whose hospital offers transgender services to three-year-olds.

He should be happy there.

The authors contend that the AAP

…has been giving Dr. Turban a platform for years, despite the mistakes that plague his research. Pediatrics published his highly flawed 2020 study alleging that puberty blockers reduce suicide in teens.

The journal even chose the article as its “Best of 2020” despite receiving rebuttals that pointed out the rate of attempted suicide was twice as high among the puberty-blocked group and Dr. Turban hadn’t controlled for the possibility that better mental-health outcomes might be the result of factors other than hormonal intervention.

The editor of Pediatrics, the AAP journal, said he gave the award based on clicks and downloads, not “editorial choices.”

In response to a rebuttal from one of us (Julia Mason), who warned that the AAP was encouraging the misleading idea that sex can literally be changed, a reviewer said that her statement shouldn’t be published as it could be “offensive to the pediatric readership of the journal.” Pediatrics seems to be basing its editing choices on political calculation and the sensibilities of trans-identified teens.

I was informed by that, but not surprised. My own research over the past couple of years has exposed me to the gulf between opposing sides not only of the public debate, but also within elements of the psychiatric and pediatric communities on this issue.

The authors accused AAP of having been captured by child gender transformation devotees. I have noticed in these devotees a combination of messianic fervor, veils of secrecy in their medical practices, and a drive to suppress opposing views.

Plus progressive pediatricians, pediatric endocrinologists and surgeons clearly think it is cool medicine.

Cooler than treating runny noses.

On the suppression-of-debate front, again from the WSJ op-ed:

Last year a resolution was submitted to the AAP’s annual leadership forum to inform the academy’s 67,000 members about the growing international skepticism of pediatric gender transition. It asked for a thoughtful update to the current practice of affirmation on demand.

Even though the resolution was in the top five of interest based on votes by members cast online, the AAP’s leadership voted it down. In their newsletter, they decried the resolution as transphobic and noted that only 57 members out of 67,000 had endorsed it.

The following year, however, when only 53 members backed a resolution that supported affirmative intervention, the AAP allowed the motion to go through, saying that the previous year’s measure was “soundly defeated” while this year’s received “broad support.” When members submitted another resolution to conduct a review of the evidence, the AAP enforced for the first time a rule that shut down member comments, effectively burying it.

As I said, my experience in researching the AAP website matches that of Dr. Mason. I have never read a discouraging word there about puberty blockers, cross-gender hormones or surgery in treatment of gender dysphoric children.

So much for the backstage politics that taint the professionalism of the AAP and therefore the public debate.

The real news was that other science-driven medical societies around the world have placed severe restrictions on medical transition for minors.

The extensive review in the U.K. by its National Health Services of its Gender Identity Services for children and young people begun in late 2020 is perhaps the most concerning. It has been very extensive and the most up-to-date.

I will follow this article with a dive into the current status of that review.

Suffice it to say for the moment that it has uncovered gaping holes in the science of transgender medical transitions in children and pointed out that the procedures continue without sufficient scientific evidence.

Bottom line, all of this brings into great question the AAP’s suppression of debate.

And into great question whether what is being done with puberty blockers and cross-gender hormones in certain pediatric medicine practices today in this country could survive the same kind of review ongoing in Britain.


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18 responses to “Medical Gender Transition in Children – American Academy of Pediatrics Headquarters vs. the World”

    1. James Wyatt Whitehead Avatar
      James Wyatt Whitehead

      Great song. Paul Cotton nails it. Rusty was an underappreciated song writer. Both gone now.

  1. Looking at the study, the “twice as much” claim seems to stem from the puberty blocker group having twice as many attempts that required impatient care (45% vs 22%). Attempts without need to care were roughly the same (24% to 21%) and in the other two categories were lower (ideation and ideation with plan but no attempt).

    However, these were only in the last twelve months. Over lifetime, the blocker group had 15% less suicidal thoughts and 10% fewer attempts. Seems like Mason and company are cherrypicking data to make it sound more sinister, but this is all present in the study.

    If you want to critique the study, then look at the sample size: 89 people in the blocker category vs 3405 non-blocker people. A sample of 89 is just not large enough, and is naturally going to make the percents compare strangely. The blocker group had just 5 suicide attempts with hospital care, but the sample is so small that it makes it looks rather alarming when you compare the percents to the non-blocker group. This is likely unavoidable, as puberty blockers for transgender kids are relatively new and going to make it difficult for large sample sizes.

    So while the overall data is encouraging, it would need larger sample sizes and more rigor before we could draw concrete conclusions. Also, Dr. Mason also admits to not being an academic, so her critiques of studies are going to be coming from a lack of experience.

    Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/

    1. James C. Sherlock Avatar
      James C. Sherlock

      You assess Tanner’s work. So did Dr. Mason. You come to different conclusions about the validity of the study. Free country.

      You say “Dr. Mason also admits to not being an academic, so her critiques of studies are going to be coming from a lack of experience”. The woman is a trained pediatrician. I will assume that statement is not mysogynistic. See, we differ in approach already.

      To remind, after earning their undergraduate degree, aspiring pediatricians go on to complete four years of medical school. They must then spend three years at an accredited pediatric residency program. Then they go into practice.

      And you contend that Dr. Mason lacks experience. And perhaps this is her first look at a study, much less a study derivative of a survey. Really?

      Are you Dr. Rosie?

      Even if you were, both of you know it was a derivative study and, being professionals, examine the survey from which Dr. Tanner’s data were derived.

      The data he used were collected in the summer of 2015 by the National Center for Transgender Equality, the US Transgender Survey (USTS) was an anonymous, online survey for transgender adults (18 and older) in the United States, available in English and Spanish.

      Read:
      “A Note About 2015 U.S. Trans Survey Delays”

      “Yesterday, we opened up the 2015 U.S. Trans Survey for people to complete and learned that even our 7 servers could not keep up with the number of enthusiastic participants. “

      Enthusiastic. And probably no one messed with it.

      That same organization is about to redo the survey. Look how they are controlling the inputs https://transequality.org/blog/pledge-now-to-take-the-2022-us-trans-survey

      Rosie, you can go online, take a pledge to participate, and say you are either transsexual or will gather up transsexual friends and help them participate. Then you will receive the survey. Your friends will get one too.

      See pledge at https://secure.transequality.org/site/SSurvey;jsessionid=00000000.app20071a?NONCE_TOKEN=E25ADDCF085C8B4F1F51F93A57C60FD6&ACTION_REQUIRED=URI_ACTION_USER_REQUESTS&SURVEY_ID=3401

      Absolutely no one will screw with this one either. The responses will probably be even more enthusiastic.

      BTW, the comprehensive report on the survey advises
      “12% have done sex work in exchange for income—and 9% did so in the past year, with higher rates among women of color”. Not what I would want for children, but, as I wrote, it’s a free country. You may disagree.

      There is no indication in the report of whether kids who took puberty blockers and as a result look more attractive to men and women seeking partners than those who did not are more or less likely to be prostitutes.

      For the survey report done by those who originally collected the data see https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf

      We should get more prostitution data in the 2022 survey. Hang in there.

      1. You’ll ignore your attempt to poison the well with misogyny accusations. Just want to make it clear that appeals to authority are not valid, and Mason is bot a researcher and interpreting data is different than treating patients. I mean, I wouldn’t want the researchers as my physicians.

        I am not sure why you are going on about the survey. Regardless of outcome it had a small sample size and treating one statistic as something being covered up is not being accurate. And I was also hesitant to take too much, positive or negative, from the sample as a result. Did it get the award for its results or for actually doing research in a new area? I don’t have access to the article.

        As for your non-sequitur, it’s not a secret that transgender people have to rely more on sex work to survive as the result of…being kicked out of their homes by their parents. So you can expect that number to increase if your proposals come to pass. This is like blaming a student’s depression on wearing glasses and not the students calling them “four-eyes.”

        1. My depression was the result of having to wear glasses because it prevented me from becoming a fighter pilot. And I’ve been called a hell of a lot worse things than “four-eyes”.

          Insults from other people can only depress you if you let them, and that’s a personal choice. Having a life-long dream shattered through no fault of your own is a whole lot harder to shrug off.

        2. James C. Sherlock Avatar
          James C. Sherlock

          What did you miss about “I will assume that statement is not mysogynistic”.

        3. James C. Sherlock Avatar
          James C. Sherlock

          I just cited it as an outcome of gender transition. You assume it is because they were “kicked out”.

          Convenient to your narrative, but where is your data for that assumption?

  2. James Kiser Avatar
    James Kiser

    Thekids can’t vape but they can mutate according to “science”. LOL

    1. Eric the half a troll Avatar
      Eric the half a troll

      You want kids to be able to vape?

      1. I think they should be able to vape at age 18. That’s the same age I think they should be able to begin to have their bodies surgically mutilated – also, the age at which they should be legally permitted to drink alcohol, smoke, and engage in other potentially harmful personal behaviors that we currently restrict or prohibit until age 21.

        1. Matt Adams Avatar
          Matt Adams

          21 is just so arbitrary, I agree. Age of majority opens the doors, period.

        2. Eric the half a troll Avatar
          Eric the half a troll

          I don’t disagree with you. At least they should have parental oversight if they are allowed to take such action… (last I looked a minor could drink in their house under parent supervision – think family meals – in Virginia, for instance). Why any parent would condone vaping is beyond me but it takes all kinds. I, personally, feel the same about surgical transitioning but again I don’t know the situation the child and their parents are facing and don’t believe the legislature should make that call for them.

          1. (last I looked a minor could drink in their house under parent supervision – think family meals – in Virginia, for instance)

            That is correct. Many people do not know that.

            Of course, a minor child’s minor friends drinking in your house do not qualify for that exemption. 😉

          2. James C. Sherlock Avatar
            James C. Sherlock

            Vaping is worse than mutilation and sterilization? Really?

          3. Eric the half a troll Avatar
            Eric the half a troll

            Ummmm… didn’t say or imply that…

        3. Eric the half a troll Avatar
          Eric the half a troll

          I don’t disagree with you. At least they should have parental oversight if they are allowed to take such action… (last I looked a minor could drink in their house under parent supervision – think family meals – in Virginia, for instance). Why any parent would condone vaping is beyond me but it takes all kinds. I, personally, feel the same about surgical transitioning but again I don’t know the situation the child and their parents are facing and don’t believe the legislature should make that call for them.

    2. killerhertz Avatar
      killerhertz

      The AAP is such a corrupt organization as evidenced by COVID policy, that I wouldn’t be surprised if they endorsed sex trafficking as good for children’s health!

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