On Thursday, the American Academy of Paediatrics reaffirmed its 2018 stance in support of gender-related therapies for children, a medical technique that has since been prohibited in 19 states.
Following comparable attempts in Europe that revealed ambiguous evidence of their usefulness in teenagers, the powerful group of physicians also went the further step of commissioning a systematic evaluation of medical research on the therapies.
The dramatic rise in the number of teenagers who identify as transgender in recent years has prompted calls for a deeper look at the evidence from critics across the political spectrum, including a small but vociferous group of paediatricians.
Due to the novelty of the therapies, there has been less research on their long-term effects. After conducting systematic reviews, the gold standard for reviewing medical research, health authorities in England and Sweden restricted access to the therapies.
Once the evaluation is over, the panel will publish updated recommendations and new clinical guidelines for physicians, he added.
At a meeting on Thursday in Itasca, Ill., all 16 members of the A.A.P. board, who together speak for 67,000 paediatricians throughout the United States, decided to reaffirm the 2018 standards. The decision comes at a time when transgender persons and the clinicians who treat them are under significant political pressure.
Gender-affirming treatment, which may involve psychotherapy, puberty-blocking medicines, hormones, and very rare operations, has been prohibited by Republican legislators throughout the nation during the last two years. Critics of the service say it’s unsafe since it’s experimental and because youngsters can’t provide informed permission.
The A.A.P. has submitted amicus briefs in support of the many legal challenges launched against the bans by civil rights organisations and has strongly opposed the legislative bans as a hazardous intervention into complicated medical choices between physicians and families.
The Academy’s 2018 prior policy statement strongly backed gender-affirming therapy, stating that such treatments were necessary and should be reimbursed by health insurance. Early data revealed that gender-affirming treatment might benefit the mental health of transgender teenagers, who have high rates of anxiety, depression, and suicide attempts.
After five years, position statements like those voted on today may be reviewed to either be confirmed, retired, or altered based on new evidence. The 2017 academy recommendation letting infants start eating peanuts after a key research showed that doing so might help avoid fatal allergies is an example of such a reversal.
Some researchers were critical of the choice to keep recommending the medicines for children and adolescents without first conducting a thorough evaluation.
The move is “very clearly putting the cart before the horse,” according to Dr Gordon Guyatt, a clinical epidemiologist at McMaster University who pioneered the area of evidence-based medicine.
Previous systematic reviews suggest low-quality evidence for paediatric gender care, therefore Dr. Guyatt expects that to be the case in the A.A.P.’s report. He said that the European Union’s policies were more in line with the facts than the United States’.
A comparable evaluation has been requested by a subset of American paediatricians from the A.A.P., one of the only organisations with sufficient centralised authority to affect health care practises in the country. Dr. Julia Mason is a paediatrician in Gresham, Oregon, who has been quite critical of gender therapies for children and adolescents. She co-founded an organisation called the Society for Evidence-Based Gender Medicine. She claims that she has been trying to get the academy’s administration to fund a systematic study since 2020, but to no avail.
She also said that many clinicians, especially those working with children, employ medications that haven’t been subjected to extensive clinical testing. Not all American states have outright prohibited the treatment, but Europe has.
