Republican states are investigating the guidelines on transgender care for minors from the American Academy of Pediatrics, questioning whether the premier children’s medicine board is complying with state consumer protection laws.
Attorneys general and Republican leadership in 21 states, led by Raul Labrador of Idaho, sent a letter to the AAP on Tuesday arguing that the medical board is deceiving patients through its support for using hormonal treatments and surgical interventions to treat minors with gender dysphoria.
“The most basic tenant of medicine — do no harm — has been abandoned by professional associations when politically pressured,” Labrador said in a press release announcing the letter. “These organizations are sacrificing the health and well-being of children with medically unproven treatments that leave a wake of permanent damage.”
The letter specifically targets the AAP’s endorsement of using puberty blockers on prepubescent children who struggle with gender identity under the auspices that the medication is fully reversible, a claim that has been hotly debated.
In 2023, the AAP doubled down on its 2018 policy statement supporting “gender-affirming care” for the treatment of gender dysphoria, endorsing puberty blockers, cross-sex hormones, and surgical intervention.
At that time, the medical board also authorized a systematic review of the evidence to guide further developments in gender transition medicine for minors, the results of which have not yet been publicized.
“Whatever the status of that ‘systematic review,’ the AAP continues to mislead and deceive consumers by maintaining its claim that puberty blockers are ‘reversible.’ That claim is misleading and deceptive and requires immediate retraction and correction,” the Republican leaders wrote.
A massive shift in the debate occurred earlier this year when the British National Health Service commissioned a study on transgender medicine for minors from renowned pediatrician Hilary Cass.
The Cass Report, published in April and referenced in the letter, highlights evidence that puberty blockers can interfere with a child’s neurocognitive development, bone density, metabolic health, and psychological development.
Cass also wrote in the nearly 400-page report that the argument for the efficacy of cross-sex hormones and surgical interventions for youth gender dysphoria is built on a foundation of “remarkably weak evidence,” particularly of the long-term ramifications.
“It is abusive to treat a child with biologically altering drugs that have an unknown physiological trajectory and end point,” the Republican leaders wrote to the AAP. “It is also inhumane to endorse such experimentation without a confident safety profile, especially if more times than not, it proves to be medically unnecessary.”
The letter also references documents uncovered in June that demonstrate a different medical organization, the World Professional Association for Transgender Health, was pressured by senior Biden-Harris administration officials to reduce the age requirements for surgical intervention on minors from their international guidance on youth gender medicine.
More than half of the states in the United States, a total of 26, have passed some sort of ban on transgender medicine for minors. Legislation is now being blocked by court order in two states, Arkansas and Montana, and there is pending litigation against the laws in 13 others.
The Supreme Court is set to hear a case this term regarding the constitutionality of state laws in Tennessee and Kentucky that prohibit the use of puberty blockers and cross-sex hormones for treating minors with gender dysphoria. Oral arguments for the case, US v. Skrmetti, have not yet been scheduled.
The leaders requested information from the AAP about the group’s transgender health policies by Oct. 28.
“Children with gender dysphoria need and deserve love, support, and medical care rooted in biological reality,” Labrador said. “Parents should be able to trust that a doctor’s medical guidance isn’t just the latest talking point from a dangerous and discredited activist agenda.”