https://www.acpeds.org/the-college-spea ... n-childrenABSTRACT: Gender dysphoria (GD) of childhood describes a psychological condition in which children experience a marked incongruence between their experienced gender and the gender associated with their biological sex. When this occurs in the pre-pubertal child, GD resolves in the vast majority of patients by late adolescence. Currently there is a vigorous, albeit suppressed, debate among physicians, therapists, and academics regarding what is fast becoming the new treatment standard for GD in children. This new paradigm is rooted in the assumption that GD is innate, and involves pubertal suppression with gonadotropin releasing hormone (GnRH) agonists followed by the use of cross-sex hormones—a combination that results in the sterility of minors. A review of the current literature suggests that this protocol is founded upon an unscientific gender ideology, lacks an evidence base, and violates the long-standing ethical principle of “First do no harm.”
Gender Dysphoria in Children: This Debate Concerns More than Science
Gender is a term that refers to the psychological and cultural characteristics associated with biological sex.1 It is a psychological concept and sociological term, not a biological one. Gender identity refers to an individual’s awareness of being male or female and is sometimes referred to as an individual’s “experienced gender.” Gender dysphoria (GD) in children describes a psychological condition in which they experience marked incongruence between their experienced gender and the gender associated with their biological sex. They often express the belief that they are the opposite sex.2 The prevalence rates of GD among children has been estimated to be less than 1%.3 Sex differences in rate of referrals to specialty clinics vary by age. In pre-pubertal children, the ratio of boys to girls ranges from 2:1 to 4.5:1. In adolescents, the sex ratio is close to parity; in adults, the ratio of males to females range from 1:1 to 6.1:1.2
The debate over how to treat children with GD is primarily an ethical dispute; one that concerns physician worldview as much as science. Medicine does not occur in a moral vacuum; every therapeutic action or inaction is the result of a moral judgment of some kind that arises from the physician’s philosophical worldview. Medicine also does not occur in a political vacuum and being on the wrong side of sexual politics can have severe consequences for individuals who hold the politically incorrect view.
As an example, Dr. Kenneth Zucker, long acknowledged as a foremost authority on gender identity issues in children, has also been a lifelong advocate for gay and transgender rights. However, much to the consternation of adult transgender activists, Zucker believes that gender-dysphoric pre-pubertal children are best served by helping them align their gender identity with their anatomic sex. This view ultimately cost him his 30-year directorship of the Child Youth and Family Gender Identity Clinic (GIC) at the Center for Addiction and Mental Health in Toronto.4,5
Many critics of pubertal suppression hold a modernist teleological worldview. They find it self-evident that there is a purposeful design to human nature, and that cooperation with this design leads to human flourishing. Others, however, identify as post-modernists who reject teleology. What unites the two groups is a traditional interpretation of “First do no harm.” For example, there is a growing online community of gay-affirming physicians, mental health professionals, and academics with a webpage entitled “First, do no harm: youth trans critical professionals.” They write:
We are concerned about the current trend to quickly diagnose and affirm young people as transgender, often setting them down a path toward medical transition…. We feel that unnecessary surgeries and/or hormonal treatments which have not been proven safe in the long-term represent significant risks for young people. Policies that encourage—either directly or indirectly—such medical treatment for young people who may not be able to evaluate the risks and benefits are highly suspect, in our opinion.6
Advocates of the medical interventionist paradigm, in contrast, are also post-modernists but hold a subjective view of “First do no harm.” Dr. Johanna Olson-Kennedy, an adolescent medicine specialist at Children’s Hospital Los Angeles, and leader in pediatric gender transitioning, has stated that “[First do no harm] is really subjective. [H]istorically we come from a very paternalistic perspective… [in which] doctors are really given the purview of deciding what is going to be harmful and what isn’t. And that, in the world of gender, is really problematic.”7 Not only does she claim that “First do no harm” is subjective, but she later also states that it should be left to the child decide what constitutes harm based upon their own subjective thoughts and feelings.7 Given the cognitive and experiential immaturity of the child and adolescent, the American College of Pediatricians (the College) finds this highly problematic and unethical.
Gender dysphoria as the result of an innate internal sexed identity
Professor of social work, Dr. William Brennan, has written that “[t]he power of language to color one’s view of reality is profound.”8 It is for this reason that linguistic engineering always precedes social engineering — even in medicine. Many hold the mistaken belief that gender once meant biological sex. Though the terms are often used interchangeably they were never truly synonymous.9,10 Feminists of the late 1960’s and 1970’s used gender to refer to a “social sex” that could differ from one’s “biological sex” in order to overcome unjust discrimination against women rooted in sex stereotypes. These feminists are largely responsible for mainstreaming the use of the word gender in place of sex. More recently, in an attempt to eliminate heteronormativity, queer theorists have expanded gender into an excess of 50 categories by merging the concept of a social sex with sexual attractions.9 However, neither usage reflects the original meaning of the term.
Prior to the 1950s, gender applied only to grammar not to persons.9,10 Latin based languages categorize nouns and their modifiers as masculine or feminine and for this reason are still referred to as having a gender. This changed during the 1950s and 1960s as sexologists realized that their sex reassignment agenda could not be sufficiently defended using the words sex and transsexual. From a purely scientific standpoint, human beings possess a biologically determined sex and innate sex differences. No sexologist could actually change a person’s genes through hormones and surgery. Sex change is objectively impossible. Their solution was to hijack the word gender and infuse it with a new meaning that applied to persons. John Money, PhD was among the most prominent of these sexologists who redefined gender to mean ‘the social performance indicative of an internal sexed identity.10 In essence, these sexologists invented the ideological foundation necessary to justify their treatment of transsexualism with sex reassignment surgery and called it gender. It is this man-made ideology of an ‘internal sexed identity’ that now dominates mainstream medicine, psychiatry and academia. This linguistic history makes it clear that gender is not and never has been a biological or scientific entity. Rather, gender is a socially and politically constructed concept.
also of interest for the strong of stomach:
Gender-affirmative therapist: Baby who hates barrettes = trans boy; questioning sterilization of 11-year olds same as denying cancer treatment
Has the UK become a police state? (And has Twitter become its informant?)