Gender Ideology Harms Children | American College of Pediatricians
Gender Ideology Harms Children
Updated January 2017
The American College of Pediatricians
urges healthcare professionals, educators and legislators to reject all
policies that condition children to accept as normal a life of chemical
and surgical impersonation of the opposite sex. Facts – not ideology –
determine reality.
1.
Human sexuality is an objective biological binary trait:
“XY” and “XX” are genetic markers of male and female, respectively – not
genetic markers of a disorder. The norm for human design is to
be conceived either male or female. Human sexuality is binary by design
with the obvious purpose being the reproduction and flourishing of our
species. This principle is self-evident. The exceedingly rare disorders
of sex development (DSDs), including but not limited to testicular
feminization and congenital adrenal hyperplasia, are all medically
identifiable deviations from the sexual binary norm, and are rightly
recognized as disorders of human design. Individuals with DSDs (also
referred to as “intersex”) do not constitute a third sex.
1
2.
No one is born with a gender. Everyone is born with a
biological sex. Gender (an awareness and sense of oneself as male or
female) is a sociological and psychological concept; not an objective
biological one. No one is born with an awareness of themselves
as male or female; this awareness develops over time and, like all
developmental processes, may be derailed by a child’s subjective
perceptions, relationships, and adverse experiences from infancy
forward. People who identify as “feeling like the opposite sex” or
“somewhere in between” do not comprise a third sex. They remain
biological men or biological women.
2,3,4
3.
A person’s belief that he or she is something they are not is, at best, a sign of confused thinking.
When an otherwise healthy biological boy believes he is a girl, or an
otherwise healthy biological girl believes she is a boy, an objective
psychological problem exists that lies in the mind not the body, and it
should be treated as such. These children suffer from gender dysphoria.
Gender dysphoria (GD), formerly listed as Gender Identity Disorder
(GID), is a recognized mental disorder in the most recent edition of the
Diagnostic and Statistical Manual of the American Psychiatric
Association (DSM-V).
5 The psychodynamic and social learning theories of GD/GID have never been disproved.
2,4,5
4.
Puberty is not a disease and puberty-blocking hormones can be dangerous. Reversible
or not, puberty- blocking hormones induce a state of disease – the
absence of puberty – and inhibit growth and fertility in a previously
biologically healthy child.
6
5.
According to the DSM-V, as many as 98% of gender confused
boys and 88% of gender confused girls eventually accept their biological
sex after naturally passing through puberty.5
6.
Pre-pubertal children who use puberty blockers to
impersonate the opposite sex will require cross-sex hormones in late
adolescence. This combination leads to permanent sterility. These
children will never be able to conceive any genetically related children
even via artificial reproductive technology. In addition, cross-sex
hormones (testosterone and estrogen) are associated with dangerous
health risks including but not limited to cardiac disease, high blood
pressure, blood clots, stroke, diabetes, and cancer.7,8,9,10,11
7.
Rates of suicide are nearly twenty times greater among
adults who use cross-sex hormones and undergo sex reassignment surgery,
even in Sweden which is among the most LGBTQ – affirming countries.12 What
compassionate and reasonable person would condemn young children to
this fate knowing that after puberty as many as 88% of girls and 98% of
boys will eventually accept reality and achieve a state of mental and
physical health?
8.
Conditioning children into believing a lifetime of
chemical and surgical impersonation of the opposite sex is normal and
healthful is child abuse. Endorsing gender discordance as
normal via public education and legal policies will confuse children and
parents, leading more children to present to “gender clinics” where
they will be given puberty-blocking drugs. This, in turn, virtually
ensures they will “choose” a lifetime of carcinogenic and otherwise
toxic cross-sex hormones, and likely consider unnecessary surgical
mutilation of their healthy body parts as young adults.
Michelle A. Cretella, M.D.
President of the American College of Pediatricians
Quentin Van Meter, M.D.
Vice President of the American College of Pediatricians
Pediatric Endocrinologist
Paul McHugh, M.D.
University Distinguished Service Professor of Psychiatry at Johns
Hopkins Medical School and the former psychiatrist in chief at Johns
Hopkins Hospital
Originally published March 2016
Updated August 2016
Updated January 2017
CLARIFICATIONS in response to FAQs regarding points 3 & 5:
Regarding Point 3: “Where does the APA or DSM-V indicate that Gender Dysphoria is a mental disorder?”
The APA (American Psychiatric Association) is the author of the
Diagnostic and Statistical Manual of Mental Disorders, 5th edition(DSM-V).
The APA states that those distressed and impaired by their GD meet the
definition of a disorder. The College is unaware of any medical
literature that documents a gender dysphoric child seeking puberty
blocking hormones who is not significantly distressed by the thought of
passing through the normal and healthful process of puberty.
From the
DSM-V fact sheet:
“The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition.”
“This condition causes clinically significant distress or impairment
in social, occupational, or other important areas of functioning.”
Regarding Point 5: “Where does the DSM-V list rates of resolution for Gender Dysphoria?”
On page 455 of the DSM-V under “Gender Dysphoria without a disorder of sex development” it states:
“Rates
of persistence of gender dysphoria from childhood into adolescence or
adulthood vary. In natal males, persistence has ranged from 2.2% to 30%.
In natal females, persistence has ranged from 12% to 50%.” Simple math
allows one to calculate that for natal boys: resolution occurs in
as many as 100% – 2.2% = 97.8% (approx. 98% of gender-confused boys) Similarly, for natal girls: resolution occurs in
as many as 100% – 12% = 88% gender-confused girls
The bottom line is this: Our
opponents advocate a new scientifically baseless standard of care for
children with a psychological condition (GD) that would otherwise
resolve after puberty for the vast majority of patients concerned.
Specifically, they advise: affirmation of children’s thoughts which
are contrary to physical reality; the chemical castration of these
children prior to puberty with GnRH agonists (puberty blockers which
cause infertility, stunted growth, low bone density, and an unknown
impact upon their brain development), and, finally, the permanent
sterilization of these children prior to age 18 via cross-sex hormones.
There is an obvious self-fulfilling nature to encouraging young GD
children to impersonate the opposite sex and then institute pubertal
suppression. If a boy who questions whether or not he is a boy (who is
meant to grow into a man) is treated as a girl, then has his natural
pubertal progression to manhood suppressed, have we not set in motion an
inevitable outcome? All of his same sex peers develop into young men,
his opposite sex friends develop into young women, but he remains a
pre-pubertal boy. He will be left psychosocially isolated and alone. He
will be left with the psychological impression that something is wrong.
He will be less able to identify with his same sex peers and being male,
and thus be more likely to self identify as “non-male” or female.
Moreover, neuroscience reveals that the pre-frontal cortex of the brain
which is responsible for judgment and risk assessment is not mature
until the mid-twenties. Never has it been more scientifically clear that
children and adolescents are incapable of making informed decisions
regarding permanent, irreversible and life-altering medical
interventions. For this reason, the College maintains it is abusive to
promote this ideology, first and foremost for the well-being of the
gender dysphoric children themselves, and secondly, for all of their
non-gender-discordant peers, many of whom will subsequently question
their own gender identity, and face violations of their right to bodily
privacy and safety.
For more information, please visit this page on the College website concerning sexuality and gender issues.
A PDF version of this page can be downloaded here: Gender Ideology Harms Children
References:
1. Consortium on the Management of Disorders of Sex Development,
“Clinical Guidelines for the Management of Disorders of Sex Development
in Childhood.” Intersex Society of North America, March 25, 2006.
Accessed 3/20/16 from http://www.dsdguidelines.org/files/clinical.pdf.
2. Zucker, Kenneth J. and Bradley Susan J. “Gender Identity and Psychosexual Disorders.”
FOCUS: The Journal of Lifelong Learning in Psychiatry. Vol. III, No. 4, Fall 2005 (598-617).
3. Whitehead, Neil W. “Is Transsexuality biologically determined?”
Triple Helix
(UK), Autumn 2000, p6-8. accessed 3/20/16 from
http://www.mygenes.co.nz/transsexuality.htm; see also Whitehead, Neil W.
“Twin Studies of Transsexuals [Reveals Discordance]” accessed 3/20/16
from http://www.mygenes.co.nz/transs_stats.htm.
4. Jeffreys, Sheila.
Gender Hurts: A Feminist Analysis of the Politics of Transgenderism. Routledge, New York, 2014 (pp.1-35).
5. American Psychiatric Association:
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Arlington, VA, American Psychiatric Association, 2013 (451-459). See page 455 re: rates of persistence of gender dysphoria.
6. Hembree, WC, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline.
J Clin Endocrinol Metab. 2009;94:3132-3154.
7. Olson-Kennedy, J and Forcier, M. “Overview of the management of
gender nonconformity in children and adolescents.” UpToDate November 4,
2015. Accessed 3.20.16 from www.uptodate.com.
8. Moore, E., Wisniewski, & Dobs, A. “Endocrine treatment of
transsexual people: A review of treatment regimens, outcomes, and
adverse effects.”
The Journal of Endocrinology & Metabolism, 2003; 88(9), pp3467-3473.
9. FDA Drug Safety Communication issued for Testosterone products
accessed 3.20.16:
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm161874.htm.
10. World Health Organization Classification of Estrogen as a Class I
Carcinogen:
http://www.who.int/reproductivehealth/topics/ageing/cocs_hrt_statement.pdf.
11. Eyler AE, Pang SC, Clark A. LGBT assisted reproduction: current practice and future possibilities.
LGBT Health 2014;1(3):151-156.
12. Dhejne, C, et.al. “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden.”
PLoS ONE,
2011; 6(2). Affiliation: Department of Clinical Neuroscience, Division
of Psychiatry, Karolinska Institutet, Stockholm, Sweden. Accessed
3.20.16 from
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885.
