The Politics of Gender Mania at the American Academy of Pediatrics

The guiding medical principle “to do no harm,” attributed to the ancient Greeks, is one of Western civilization’s oldest professional norms. Whereas Greek doctors swore to the god Apollo to do no harm to their patients, today’s doctors increasingly sacrifice patient wellbeing on the altar of transgender ideology.

Even at the American Academy of Pediatrics (AAP), where doctors are meant to protect the health of children, transgender ideology now reigns supreme. Last month, AAP president Dr. Moira Szilagyi expressed her pride in promoting so-called “gender-affirming care” as one of the association’s values. Dr. Szilagyi similarly smeared opponents of gender-affirming care as part of a “dangerous movement” led by “extremists” and motivated by “disinformation.”

The AAP’s support of gender-affirming care is no small matter for pediatric medicine, the medical profession, and the countless Americans who require pediatric care. As an organization, the AAP represents 67,000 pediatricians across the nation and is one of the premier agenda-setting organizations in contemporary medicine. At its most recent leadership conference, the AAP included transgender care among its top priorities.

[Related: “Defund Gender Studies”]

In 2018, the AAP published a language guide through its flagship journal, Pediatrics, to assist in caring for transgender youth and to recommend treating gender dysphoria through puberty blockers, hormone therapy, and surgery to reshape and reform a patient’s appearance to match his desired gender. The AAP labels transgender youth as “gender-diverse,” a euphemism that avoids treating gender dysphoria as a mental health problem. The AAP is not simply an institution falling to the pressure of a woke mob, but rather a flagship organization and thought leader behind the normalization of transgender youth surgery—often irreversible operations that can adversely affect the trajectory of a child’s life. Surgeries and hormone blockers can lead to disfigurement and sterilization.

In 2022, another study in Pediatrics asserted that instances of “re-transitioning”—transgender youth changing back to represent their biological sex—are uncommon. This is despite evidence to the contrary. In fact, the majority of boys claiming to be girls prior to transitioning later revert back to identifying as boys, while many trans youth later regret the decision to change their gender in the first place.

Ostensibly apolitical, the AAP is instrumental in directing policy and political debates surrounding children with gender dysphoria. As parents mobilized over the growing prominence of sexuality in K–12 schools, the AAP has offered the legitimacy of the medical profession to the political activity of transgender activists. Notably, the AAP’s efforts are aimed not only at smearing opponents of transgender ideology as extremists, but also at silencing dissent among physicians who disagree with the organization’s political agenda. Indeed, the AAP’s transgender guidance shapes the policies of the Biden administration.

In October 2021, the AAP denied the Society for Evidence-Based Gender Medicine a booth at its annual conference due to the Society’s hesitancy to accept its aggressively imposed orthodoxy on gender-affirming care. Ironically, the AAP’s denial came amid substantial dissent from within its own membership, as pediatricians advocated for debating alternatives to “medical transitioning.” Additionally, the AAP’s hardline stance on gender-affirming hormone therapy and surgery comes amid an international shift away from such treatments. Indeed, Sweden, Finland, the UK, France, Belgium, and Australia all injected a dose of sanity by easing back on such treatments. Despite the global move toward sexual and gender sanity, though, the Biden administration is pressuring gender transition norms abroad through diplomacy and advocacy.

[Related: “The Perils of Challenging Trans Activism at Mount Royal University”]

The AAP’s institutional policy promoting medical treatment for gender dysphoria reeks of political totalitarianism rather than sound science. The AAP’s recent assertions to “trust the science” on transgenderism, and its claim that the increase in gender dysphoria lay not in social pressures but in biology, was recently met by backlash from doctors and scientists. The AAP’s hardline stance on promoting medical treatment for a mental disorder among minors has rendered the US an outlier among the Western countries now curtailing medical procedures for transgender minors due to the risks involved.

Meanwhile in America, the AAP rushes forward with its own orthodoxy. In response to criticism of such orthodoxy in light of international trends, AAP president Moira Szilagyi asserted that the organization simply wants to support those “young people who are trying only to live their lives as their true selves.” Therein lies the rub, as young people are not yet done developing their “true selves.” Ignoring this reality, the AAP encourages these troubled youth make potentially irreversible and debilitating decisions. As stated by dissident scholars Julia Mason and Leo Sapir, it behooves the AAP to separate psychiatric treatment from medical intervention in treating gender dysphoria.

Ultimately, the AAP’s shift from “do no harm” to “do harm now to avoid potential harm later” is a clinic in institutional power as much as it is a case study in medical malpractice. A preeminent association like the AAP can destroy careers, shape regulation, inform legislation, and, ultimately, transform patients’ bodies. In this case, the AAP’s stance is adversely damaging the lives and bodies of innocent children before they are mature enough to make their own choices.

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