WDI USA Statement and Call for Resignation Concerning the Recent AAP Announcement About “Gender-Affirming Care” for Children

On August 22, 2022, The Post Millennial reported that the American Academy of Pediatrics (AAP) president appeared to be backtracking on the organization’s position on the administration of so-called “gender-affirming care” for minors. The president, Moira Szilagyi, had published an open letter in the Wall Street Journal stating:

In its recommendations for caring for transgender and gender-diverse young people, the AAP advises pediatricians to offer developmentally appropriate care that is oriented toward understanding and appreciating the youth’s gender experience. This care is nonjudgmental, includes families and allows questions and concerns to be raised in a supporting environment. This is what it means to ‘affirm’ a child or teen; it means destigmatizing gender variance and promoting a child’s self-worth. Gender-affirming care can be lifesaving. It doesn’t push medical treatments or surgery; for the vast majority of children, it recommends the opposite. 

Setting aside for the moment the inanity of what a medical professional might possibly mean by, or having anything to do with, a “youth’s gender experience,” or what this medical practitioner might mean by so-called “gender-diverse young people,” this appears to be in direct contradiction to the AAP’s 2018 policy, which, according to The Post Millennial:

Fully endorses ‘gender affirmation’ care, while rejecting other forms of treatment for minors experiencing gender distress, including the more cautious ‘watchful waiting’ approach. The gender affirmation model prevents medical professionals from questioning a child’s self-reported transgender identity, and from exploring possibly underlying factors causing their dysphoria. The standard protocol for gender affirmation is administering puberty blockers, followed by cross-sex hormones and then surgery, if desired.

It appears that the AAP is now attempting to publicly redefine its understanding of “gender-affirming care” to mean something more like the “watchful waiting” approach, without saying directly that it is doing so. It also appears to be attempting to distance itself from its own previous policies, and from the harms those policies have caused to countless children and their families. There has, to date, been no acknowledgement of wrongdoing by the AAP or apology to the children and their families all over the country who have been damaged by its policies at the altar of “gender identity.”

WDI USA is categorically opposed to the idea that any child ought to be “affirmed” in any way to any type of “gender experience.” Girls and boys are such on the basis of sex, purely, as all qualified medical professionals must certainly know. All of gender is a caste system designed to make women and girls subservient; this includes the imposition of compulsory heterosexuality. “Affirmation” of gender at all is politically oppressive, regressive, and damaging to women and girls as a sex class. Political conservatives these days tend to oppose so-called “gender affirming care” because they care about the safety of children, which is good. But they also tend to love the sex caste of gender. 

Article 9 section (a) of the Declaration on Women’s Sex-Based Rights states, in pertinent part:

States should recognize that medical interventions aimed at the ‘gender reassignment’ of children by the use of puberty suppressing drugs, cross-sex hormones and surgery do not serve the best interests of children. Children are not developmentally competent to give full, free, and informed consent to such medical interventions, which carry a high risk of long-term adverse consequences to the physical and psychological health of the child, and which may result in permanent adverse consequences, such as sterility. States should prohibit the use of such medical interventions upon children.

WDI USA calls on the entire Executive Committee and the Board of Directors of the AAP to resign. They are not fit to serve America’s youth. Contact information for every member of both bodies is available here. 

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In 2016 AAP published Supporting and Caring for Transgender Children. All previous AAP guidelines had been produced by physicians of the AAP. For these guidelines, though, AAP allowed activists at the Human Rights Campaign (HRC) to take the lead. The HRC, which once fought for the rights of same-sex couples and worked to end the HIV/AIDS epidemic, has been almost exclusively focused on enshrining “gender identity” in the law and throughout society since the U.S. Supreme Court’s 2015 decision in Obergefell v. Hodges, which guaranteed the right of same-sex couples to marry. 

The document has been removed from the AAP’s website, but remains available for download on the HRC website. 

The lead author of the 2016 guidelines was Gabe Murchison, a woman claiming to be a man, who served as the Senior Research Manager at HRC at the time. Murchison was neither a physician nor any kind of medical practitioner. Murchison had previously earned a BA in Women’s, Gender, & Sexuality Studies and a MPH in Social & Behavioral Sciences, and has since earned a PhD in Population Health Sciences. Of the 12 authors of those guidelines, only five were physicians. In addition to Murchison, three others were also from HRC, none of them physicians. 

Both then and now, the AAP had around 67,000 pediatrician members. It is unknown how many have ever supported the 2016 “transgender” guidelines, or how many even knew about them. To the best of our knowledge, members had no direct input in drafting the 2016 Guidelines, and were not consulted about publishing them. Unlike with other significant policy changes, there is no evidence that traditional protocols for soliciting and incorporating member input were followed.

In October of 2018, there was a significant revision of the guidelines that appeared with little to no fanfare or discussion within AAP. The 2018 guidelines were written by physicians who appear to have been recruited, or volunteered, for their adherence to “trans” dogma. AAP stated the new guidelines were published “to provide guidance for parents and clinicians through a gender-affirming approach” and that watchful waiting is deemed unsupportive. The 2018 guidelines also stated that mental health issues in these children are primarily from stigma and negative experiences due to “being trans,” rather than being intrinsic to the child (for example, experiencing depression, being bullied in school for incipient homosexuality, particular difficulties  faced by girls, autism, etc.)

This stood quietly in place until a growing contingent of AAP physicians started to take issue with the 2018 guidelines, which had not been subject to scrutiny or discussion among membership. At some point, a group of well-embedded and aggressive members who fully endorse the use of puberty blockers and surgeries on children succeeded in pushing through a policy that there was to be no debate about the 2018 guidelines at all.

In March of this year, five AAP pediatricians introduced Resolution 27. This resolution was, presumably, in response to the AAP’s call for resolution submissions to be considered during its annual conference, which took place August 4-7 of this year. The deadline for submitting was April 1, 2022, and the submitters satisfied that deadline by submitting on March 31 of this year. 

The resolution itself is straightforward and a single page long. It stated, in its entirety:

Background information provided, and well cited, to support the resolution included:

• The Cass Review, which was conducted in the U.K. earlier this year and issued an interim report expressing concern that puberty blockers and hormones may not be the best approach for all children and young people;

• The Finnish Health Authority’s 2020 systemic review and issuance of guidelines stating that psychotherapy, rather than puberty blockers and cross-sex hormones, should be the first-line treatment for dysphoric youth;

• The Royal Australian and New Zealand College of Psychiatrists’ 2021 position statement emphasizing the ‘paucity of evidence’ regarding optimal treatment for dysphoria in children and adolescents, the need for better evidence, and the importance of comprehensive assessments incorporating full consideration of context, including mental illness and personal and family history; 

• The February 2022 statement from the National Academy of Medicine urging great caution in the use of puberty blockers and cross-sex hormones in young people due to concerns about serious long term side effects; and

• The 2022 recommendations of the Swedish National Board of Health and Welfare, concluding that the risks of hormone treatment for those under 18 outweighed the benefits.

According to Genspect (an organization that seeks to protect children from the harms of puberty blockers and genital surgeries), the AAP invoked a rule that prohibited members from commenting publicly on the resolution, and according to an August 10 blog post by President Szilagyi titled Why We Stand Up for Transgender Children and Teens, the submitters “were unable to recruit a sponsor, which meant no one was willing to support their proposal,” and the resolution “did not advance because it did not receive a second vote on the floor.”

As far as we can tell, the 2018 Guidelines stand, as of today.

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In our view, the August 21 open letter by President Szilagyi reflects the dawning awareness of AAP leadership that it has done its members a tremendous disservice by stifling debate about a crucially important issue that pediatricians are sworn to take seriously in their practices. Leadership tried to be stealthy about it (in a manner consistent with the strategy recommended in this 2019 document when trying to institutionalize policies that harm children, issued by the Dentons Law Firm in association with Thomas Reuters). We suspect that AAP members discovered what was happening on their own, and they didn’t like it. Doctors don’t like being told they can’t argue about treatments. And pediatricians are mindful of their medical/ethical obligation to kids’ future health; it’s part of their training. We can only wonder how discussions about all of this transpired during this year’s annual conference.

The AAP may also be coming to grips with the travesty of its 2016 and 2018 Guidelines. No one knows how many children’s lives have been destroyed by them, how many families torn apart, how many lesbian and gay adolescents’ healthy bodies mutilated. But the time is coming when a body count will be made.

The entire Executive Committee and the Board of Directors of the AAP must resign, effective immediately.

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