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American Academy of Pediatrics releases controversial Lesbian Gay Bi Transgender Queer (LGBTQ) policy
This article has been edited for clarity and better contextualization of a source.
October 25, 2018
In a world full of changing societal norms, industries and sciences are constantly evolving. The medical field is not immune to this. One consistent ideal every doctor abides by is “Do no harm.” But what happens when “harm” could be considered subjective?
The American Academy of Pediatrics released a policy statement on Sept. 17 regarding the care of LGBTQ children, called “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents”. Gender-diverse is a term describing all the different gender labels that are used today, and care for these types of children may entail practices that could be considered harmful.
“Gender affirming care should not change anything in the doctor’s office but rather provide more positive interactions for children, adolescents and young adults with the health care system,” Chair for the Committee on Adolescence for the AAP Dr. Cora Breuner said.
Transgender children face many difficulties, and often lack the mental health resources to cope with gender dysphoria, the powerful sense of disconnection from one’s assigned sex. Some people believe that gender dysphoria should be treated as a mental illness and that doctors and parents should not encourage transgender children to identify as such. But the AAP’s statement was created in hopes of easing this stress and ensuring sufficient resources for these youth, doctors said.
“I think [the statement] will normalize things for students who are or have experienced this. If we attach the stigma of a mental health condition to gender dysphoria, it would seem to be piling on to the mountain of social and emotional problems students may already be facing,” LT’s PRISM club founder Vikki Reid said.
A controversial practice in the medical care of LGBTQ children is pubertal suppression. Pubertal suppression is the introduction of hormone-blockers, essentially “pausing” puberty, according to the Lurie Children’s Hospital of Chicago. Some doctors think this is dangerous, along with gender reassignment surgery. This includes a group of about 500 physicians who have separated from the AAP in favor of practicing medicine that more closely adheres to their socially conservative views, called the American College of Pediatrics, or ACPeds.
“We have all taken an oath to ‘First do no harm,’” Executive Director of ACPeds, Michelle Cretella, MD, and President Quentin Van Meter, MD, said in reaction to such practices. “There are many physicians and mental health professionals who know that so-called transgender pediatrics is dangerous propaganda that will permanently scar countless children both physically and mentally. We must not comply.”
Since surgical treatments and hormone blocking can lead to irreversible results in children who are still forming their identities, some professionals believe that the statement is premature and more research should be undertaken before doctors obey it, ACPeds doctors said.
“There is no rigorous science to demonstrate that transgender belief is any different from other disordered beliefs such as anorexia nervosa,” Cretella and Van Meter said. “There is no rigorous science to prove anyone is born destined to become anorexic and there is no rigorous science to prove anyone is born destined to be trans-identified.
Despite such opposing views, the AAP stands by its statement.
“In general, we have received outstanding, excellent responses and support,” Breuner said.
How a doctor must decide what to do when a young female patient says “I’m a boy” is guided by these organizations. Pediatricians must make the right choice: the stakes are high.
Astrid Fry PhD Developmental Psychologist • Oct 31, 2018 at 9:19 pm
I wish to congratulate Ms Voytovich on her excellent summary of the recent updates from the American Academy of Pediatrics. She showed journalistic integrity by accurately expressing the different opinions surrounding those updates as related to children with gender dysphoria. Given the controversial and highly sensitive nature of this topic, I am impressed with her even-handed presentation of the issues. It is all the more surprising that it was written by a high school student for a high school audience. This speaks well of the writer to be certain, but perhaps even more so of the student readership whose intellectual curiosity and emotional maturity must be very well developed to handle this level of scholarship.
Francis Hussey • Oct 31, 2018 at 8:25 pm
Interesting & timely update of a complex & often misunderstood Medical/ psychological condition presented clearly yet compassionately. Keep up the good work!
Francis X Hussey MD
Crown Point, IN
Franklin L. Smith, MD • Oct 31, 2018 at 11:44 am
I was referred to this article by a medical colleague. After reading it, I congratulate Ms. Voytovich for her efforts to navigate what is truly a controversial issue: what to do with young people who find themselves disconnected from their biological sex.
As a physician, I expect that the medical societies that represent us will develop policies primarily based on scientific research to maximize the best outcome for our patients – particularly when decisions have serious life-long repercussions. Unfortunately, such is not always the case. Gender reassignment decisions are a perfect example of this. Treatment with powerful hormones and eventually surgical reconstruction eliminates the possibility of biological childbirth and will be difficult, if not impossible, to reverse. Because these decisions are not immutable, one can be left with lifelong regret. Research showns that such regret, that may lead to suicide, occurs.
I also find it disappointing that the current climate is often intolerant of open, reasoned discussion of facts. Advocacy groups may attempt to drown out discussion which they find threaten choices they have made. Difficult as this may be, we must question and discuss serious issues, in defense of indivduals who find themselves burdened in this way.
Krishna DasGupta, M.D. • Oct 31, 2018 at 9:26 am
I read the Lion newspaper with interest. As a physician, I was glad to see Tessa Voytovich’s balanced coverage of both sides of the debate concerning the American Academy of Pediatrics’ recent guidelines for treatment of children with gender dysphoria. Too often, the debate on these issues is shaped by activism rather than evidence and clinical research. Thank you for presenting both sides.
Krishna DasGupta, M.D.