"The reality is that there is no science to back this drastic change."
On Wednesday three medical doctors spoke at a Heritage Foundation panel, an event titled “Gender Dysphoria in Children: Understanding the Science and Medicine.”
Their consensus? There’s not enough evidence to support starting gender dysphoric children on hormone therapy. Existing evidence shows doing so is actually harmful. (Scroll down for video of the discussion.)
“Thoughts and Feelings Are Not Hard-Wired”
“Biological sex is imprinted by our DNA at the moment of conception,” Michelle Cretella, M.D. said. Cretella is President of the American College of Pediatricians. Unlike DNA, she said, “thoughts and feelings are not hard-wired.”
But in recent years, thoughts and feelings have come to override biological reality. This is evident in the way pediatricians deem children eligible for hormone therapy. The American Psychiatric Association uses these guidelines for diagnosing gender dysphoria:
But relying on these items to justify permanent changes to one’s body “is not supported by science,” says Cretella. “It’s ideology.”
“The Whole Paradigm Shifted”
Paul Hruz, M.D., emphasized that whether children with gender dysphoria are truly suffering is not the question. Hruz is the Associate Professor of Pediatrics, Endocrinology, Cell Biology and Physiology at Washington University. The real question, he said, is, “Is what we’re offering to these children truly helpful to them?”
In the past when a child suffered gender identity confusion, therapists sought to help them come to terms with their body.
“Almost overnight, the whole paradigm shifted,” Hruz said. And not because of any “landmark study.”
“The reality is that there is no science to back this drastic change.”
Allan Josephson, M.D., argued this new paradigm amounts to “abandoning children.” Josephson is the Professor and Division Chief of Child and Adolescent Psychiatry at the University of Louisville. He says questions that could reveal underlying mental disorders are no longer asked.
He pointed out that people who identify as trans have more mental disorders than the general population. One study shows that over 60 percent of trans-identified people have more than one mental disorder. The Left often blames these disorders on anti-trans biases in society.
“Stigma is not enough,” however, in Josephson’s view, “to explain all the mental health problems.”
What About the Studies Showing That Trans-Identified Kids Are Happy?
Zack Ford, a writer for the liberal ThinkProgress, attended the panel. Asking the final question, he blamed the panelists’ opinions on anti-trans prejudice.
“There are studies showing that when parents affirm trans kids … mental health disparities completely disappear,” Ford said.
“There are two [studies] that I am aware of which claim that affirming your child’s gender confusion is good for them,” Cretella responded. And she said they were riddled with problems:
Number one, it assumes that coaching a child into a fixed false belief is mentally healthy. Science doesn’t allow you to assume your conclusion. Number two, those studies are extremely small. Number three, those studies are very short term. And number four, the control group of mentally healthy children … most of them were siblings of the trans-identifying child … Number five: the parents were the ones evaluating the mental health of the children. This is not science.
In the article, Ford expounds on the studies referenced in his question. One of them, as Cretella noted, relied on parents’ assessment children’s mental health. But a follow up study asked kids to determine their own levels of depression and anxiety. Trans-identified kids reported no difference in depression and anxiety than the national average. (The study included 63 trans-identified kids, 63 control children and 38 siblings.)
LGBT groups celebrated this 2016 study. Many saw it as evidence that children who transition are better off. But it’s not.
Medscape Medical News quotes Jack Turban, a young doctor who wrote an editorial accompanying the study. He called the study “very exciting.” But he warned it is not conclusive.
“These children were studied at one time point after social transition,” he said (emphasis added).
Lily Durwood, a graduate student who led the study, issued an even starker warning. “We do not have a large body of data to speak to whether social transition in prepubertal children actually has beneficial long-term outcomes,” she said. “It is too early to draw definitive conclusions.” (Emphasis added.)
Durwood pin-pointed the study’s “take-home message:” “It is possible for a child to socially transition before puberty and have normative mental health.”
It is a possibility that Josephson acknowledged on Wednesday. He said it’s not surprising that some children report happiness after their gender identity is affirmed. But what does it really mean?
If someone hates calculus, he said, and then calculus class gets removed from their course load, “you have immediate relief. You feel terrific. Because something that’s been difficult has been removed for you.”
“These studies have not been looked at very long,” he said.
Dangers of Hormone Therapy
There is no evidence that socially transitioning works long-term. But there is evidence pointing to harms of hormone therapy. And hormone therapy is what follows the social transition.
Cretella pointed out that hormone therapy for gender dysphoric children is not FDA-approved. When similar hormone therapy is used to treat prostate cancer, it can cause memory loss. Cretella said there is no study on its long-term effects on children.
“Puberty blockers also arrest brain development,” Cretella said. And after puberty blockers come cross-sex hormones. Many teens start as young as 13 or 14. Such hormones “render these children infertile,” Hruz said.
Further, Cretella explained, a girl who has been on testosterone for one year can be cleared for a double mastectomy at just 16 years old. At 18 and even younger, teens can undergo “bottom surgery.” The procedure permanently removes or restructures genitalia.
There is little data tracking people who go through all these steps, then live with the changes well into adulthood. Yet the medical community allows young children to follow this uncharted path.
“The evidence behind this new treatment paradigm is slim to none,” Hruz said.
Listen to the panel discussion here, or watch below: