Transgender children should be affirmed by their doctors, their families and society, says the American Academy of Pediatrics in an official policy statement.
The AAP’s policy is to validate all “gender identities” in children without questioning them. It ignores the possibility of children being temporarily or pathologically confused. However, it acknowledges at a number of points in the report that the scientific evidence for gender affirmation is scant. It blames this, in part, on inadequate funding for research:
“Professional understanding of youth that identify as TGD is a rapidly evolving clinical field in which research on appropriate clinical management is limited by insufficient funding.”
The new policy makes a strong argument for a “gender-affirmative care model” whose main features are that:
- “transgender identities and diverse gender expressions do not constitute a mental disorder;
- “variations in gender identity and expression are normal aspects of human diversity, and binary definitions of gender do not always reflect emerging gender identities;
- “gender identity evolves as an interplay of biology, development, socialization, and culture; and
- “if a mental health issue exists, it most often stems from stigma and negative experiences rather than being intrinsic to the child.”
With respect to medical management the policy statement contends that it should be decided on a case by case basis, but without giving any age limits and without excluding surgical intervention for adolescents. “The available data reveal that pubertal suppression in children who identify as TGD generally leads to improved psychological functioning in adolescence and young adulthood.”
The statement is sure to be controversial. A former president of the AAP and also of another medical association, the American College of Pediatricians, Dr Joseph Zanga, wrote recently:
Endorsing sex change for children as normal will inevitably lead more children to puberty-blocking drugs. This, in turn, virtually ensures they will "choose" a lifetime of toxic cross-sex hormones, and likely consider surgical mutilation of healthy body parts all for a condition that - in the vast majority of cases - would have resolved naturally by late adolescence.
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