Is the worm turning on gender affirming care for children?

The American Academy of Pediatrics orders a scientific review. Will it be conducted honestly?

The American Academy of Pediatrics said last week that it will commission a systematic review of the evidence for pediatric sex-trait modification, known euphemistically as “gender-affirming care.” This marks a turning point in the battle over the controversial medical protocol. To those who favor evidence-based rather than eminence-based medicine, it is a step in the right direction.

But it is a small step. Two key questions: Will the systematic review follow a transparent, impartial scientific process? And what should the AAP do in the meantime?

The reality is that gender affirming care is not only against the law in many countries, but the movement in Europe and Scandinavia is going even further. For instance in the UK the pediatric experts are now suggesting that children who suffer from gender dysphoria should be counseled to accept their literal physical gender, rather than embrace their feelings on the subject. In other words, they are providing gender affirming counseling, just that the gender that they are affirming is their physical gender as it exists. Based on the evidence (rather than opinions), apparently this is a healthier response.

The difference is that several countries have gone through the sort of scientific review being suggested now by the AAP and all have come to the conclusion that hormone blockers and sex changes in children provides more harm than good. They even suggest that counselling that affirms gender dysphoria is also not useful. Such research and response would be your "evidence- based" medical decision making. The eminence-based conclusions are simply the opinions of a few "experts" who then create a "scientific consensus" without bothering to do the research that evidence based research requires. For whatever reasons, the liberal side of our country seems unfond of "evidence" and would rather follow the "opinions" of the scientists that they choose to listen to.

Now if this was an honest review based on the evidence, then there is literally no reason to believe that the American research would show anything different from the European and Scandinavian research. After all evidence is evidence and a reliance on the evidences takes personal bias and political feelings out of the equation. The WSJ opinion piece suggests that the AAP may not be able to be trusted to remove their bias as it is seen as more of a trade union than a group of experts. It serves the purpose of the membership, rather than serve the greater purpose of medicine.

The article also asked a reasonable question. Why (in the meantime) we do not rely on the evidence based research already done in other parts of the world. After all, our own research is likely to take upwards of 1-2 years to complete. Do we really want to trend away from the rest of the world for the next couple of years, which (of course) will make it much more difficult for us to pivot when the evidence based research is complete. I suspect that the politics will win out over medical prudence. There is too much invested in "gender affirming care".