This is the 5th edition of my newsletter Gender Medicine Monthly, dedicated to sharing updates related to gender medicine with a particular focus on pediatric gender medicine and the affirmative model of care, for paying subscribers.
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Here are some headlines in gender medicine from the month of July (and the first week of August) covered in this edition of Gender Medicine Monthly. Related news, videos and links to additional stories and opinion pieces are provided at the end of the newsletter.
The American Academy of Pediatrics finally agrees to conduct a systematic evidence review of pediatric medical transition
International experts weigh in for the first time on pediatric gender medicine in America
England releases new details on their proposed youth gender clinic policies
2 new detransitioner lawsuits and the new law firm for detransitioners that represents them
News from Down Under: leadership changes, clinician concerns, and calls for inquiry in Australia
House Judiciary Subcommittee holds hearing on dangers of ‘gender-affirming care’
Poll found 84% of healthcare professionals in France in favor of ban on trans hormone treatments for minors
New judicial review in England seeks safeguarding for adults from medical transition services
1. The American Academy of Pediatrics finally agrees to conduct a systematic evidence review of pediatric medical transition
Source: New York Times 8/3/23 Wall Street Journal 8/3/23
The American Academy of Pediatrics is FINALLY conducting a systematic review of the evidence on pediatric medical transition. However, all 16 board members voted to back their original 2018 position in support of medical transition for minors in a meeting on Thursday.
As I reported last month, according to Resolution #37 – which requested a systematic review of evidence – the AAP had originally planned to update their policy without one. AAP leadership has ignored formal proposals like this from AAP members for four consecutive years.
The chief executive of the AAP, Mark Del Monte, told the NYT, “The board has confidence that the existing evidence is such that the current policy is appropriate. At the same time, the board recognized that additional detail would be helpful here.” When asked about the policy changes in Europe restricting pediatric medical transitions he said, “they engaged in their process, we’re engaging in our process.”
When the review is complete, they will issue updated clinical guidance for doctors, likely including recommendations.
Dr. Gordon Guyatt, a clinical epidemiologist at McMaster University and founder of the evidence-based medicine movement, told the NYT that continuing to recommend pediatric medical transition before completing a rigorous review is “very clearly putting the cart before the horse.”
Dr. Guyatt said that based on previous systematic reviews, the AAP’s report will most likely find low-quality evidence for pediatric gender care. “The policies of the Europeans are much more aligned with the evidence than are the Americans’,” he said.
The article mentions the Society for Evidence-Based Gender Medicine (SEGM) and quotes from SEGM cofounder, pediatrician, and AAP member who authored many of the Resolutions requesting evidence reviews submitted to the AAP over the years, Dr. Julia Mason.
Significance:
Most likely, the AAP will insist that they never encouraged medical interventions. We saw a glimpse of this last year when Moira Szilagyi, who at the time was the President of the AAP, replied to Leor Sapir and Julia Mason’s WSJ op-ed in a letter to the editor, saying that “gender-affirming care . . . doesn’t push medical treatments or surgery; for the vast majority of children, it recommends the opposite.”
This of course would be a welcome change, but we could do without the gaslighting. We know based on detransitioner testimony that minors are often immediately affirmed and referred for medical interventions. A Reuters investigation into 18 pediatric gender clinics in the United States revealed that evaluations typically lasted only two or so hours and seven of the clinics prescribed puberty blockers and hormones on the first visit.
2. International experts weigh in for the first time on pediatric gender medicine in America
Source: Wall Street Journal 7/13/23
21 leading experts on pediatric gender medicine from eight countries wrote a letter expressing disagreement with US-based medical organizations over the treatment of gender dysphoria in youth. They emphasize that every systematic review of evidence to date supporting the mental-health benefits of hormonal interventions for minors is of "low or very low certainty," and they express concerns about significant risks, including "sterility, lifelong dependence on medication, and the anguish of regret."
As a result, they advocate for psychotherapy as the first-line treatment for gender-dysphoric youth, adding that ‘no reliable evidence” suggests that hormonal transition is an effective suicide-prevention measure. They also raise concerns about the politicization of gender medicine in the US and advocate for an evidence-based approach, urging medical societies to align their recommendations with unbiased evidence “rather than exaggerating the benefits and minimizing the risks.”
Significance: This is the first time that international experts have publicly weighed in on the American debate over "gender-affirming care." They responded to a number of dubious claims made by Endocrine Society president, Stephen Hammes.
A dozen parents also voiced their opinions with a letter of their own, asking Dr. Hammes and the Endocrine Society to clarify “how and why they disagree with the group of international experts.” The parent letter called out Dr. Hammes's conflict of interest as the co-director of a transgender clinic that profits off of administering hormonal interventions to teens.
3. England releases new details on their proposed youth gender clinic policies
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