The Person and Identity Project applauds the recently released HHS report, Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, which identifies the serious harm and ethical concerns associated with so-called “gender affirming care.” The HHS report reviews the best evidence available, using principles of evidence-based medicine, and “brings ethical principles to bear on the evidence.” It concludes that “[t]he risks of pediatric medical transition include infertility/sterility, sexual dysfunction, impaired bone density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications, and regret.”
Instead of subjecting children and adolescents to these life-altering interventions, the HHS report calls for a better approach – addressing the child’s distress with psychotherapy, a “noninvasive alternative to endocrine and surgical interventions for the treatment of pediatric gender dysphoria.” This approach respects the unchanging reality of sex and avoids the unethical medical interventions that cause harm in otherwise healthy children, and which have irreversible effects.
It is troubling that, within hours of the report’s release, both the American Academy of Pediatrics (AAP) and WPATH, an international “transgender health” advocacy group, rejected the review’s conclusions and reiterated their support for invasive, disabling and disfiguring “gender” interventions in children. Unlike the growing number of European countries, including Denmark, Sweden, Finland, Norway, and the UK, which have restricted these interventions as experimental and unproven, the American medical establishment continues to ignore the best evidence in favor of continuing these harmful – but highly profitable – practices. This is reprehensible.
It is both encouraging and hopeful, however, that the US government has taken an evidence-based approach to these issues, within an ethical framework, and seeks to empower parents and medical providers with the information they need to care for these vulnerable children.
Key quotes include:
“[T]he ‘gender-affirming’ model of care includes irreversible endocrine and surgical interventions on minors with no physical pathology. These interventions carry risk of significant harms including infertility/sterility, sexual dysfunction, impaired bone density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications, and regret. Meanwhile, systematic reviews of the evidence have revealed deep uncertainty about the purported benefits of these interventions.”
“The evidence for benefit of pediatric medical transition is very uncertain, while the evidence for harm is less uncertain. When medical interventions pose unnecessary, disproportionate risks of harm, healthcare providers should refuse to offer them even when they are preferred, requested, or demanded by patients. Failure to do so increases the risk of iatrogenic harm and reduces medicine to consumerism, threatening the integrity of the profession and undermining trust in medical authority.”
“Suicidal ideation and behavior are independently associated with comorbidities common among children and adolescents diagnosed with gender dysphoria. Suicidal ideation and behavior have known psychotherapeutic management strategies. No independent association between gender dysphoria and suicidality has been found, and there is no evidence that pediatric medical transition reduces the incidence of suicide, which remains, fortunately, very low.”
“The principle of autonomy in medicine establishes a moral and legal right of competent patients to refuse any medical intervention. However, there is no corollary right to receive interventions that are not beneficial. Respect for patient autonomy does not negate clinicians’ professional and ethical obligation to protect and promote their patients’ health”.
To read the press release, click here. And, to read the report and summary, click here.
Additional analysis by the Catholic News Agency is available here.
