20/11/2016

GenderIdeologyHarmsChildren|AmericanCollegeofPediatricians

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Youarehere:HomeTheCollegeSpeaksPositionStatementsoftheCollegeGenderIdeologyHarms
Children

GenderIdeologyHarmsChildren
updatedAugust17,2016
TheAmericanCollegeofPediatriciansurgeseducatorsandlegislatorstorejectallpoliciesthatconditionchildren
toacceptasnormalalifeofchemicalandsurgicalimpersonationoftheoppositesex.Factsnotideology
determinereality.
1.Humansexualityisanobjectivebiologicalbinarytrait:XYandXXaregeneticmarkersofmale
andfemale,respectivelynotgeneticmarkersofadisorder.Thenormforhumandesignistobeconceived
eithermaleorfemale.Humansexualityisbinarybydesignwiththeobviouspurposebeingthereproductionand
flourishingofourspecies.Thisprincipleisselfevident.Theexceedinglyraredisordersofsexdevelopment
(DSDs),includingbutnotlimitedtotesticularfeminizationandcongenitaladrenalhyperplasia,areallmedically
identifiabledeviationsfromthesexualbinarynorm,andarerightlyrecognizedasdisordersofhumandesign.
IndividualswithDSDsdonotconstituteathirdsex.1
2.Nooneisbornwithagender.Everyoneisbornwithabiologicalsex.Gender(anawarenessandsenseof
oneselfasmaleorfemale)isasociologicalandpsychologicalconceptnotanobjectivebiologicalone.No
oneisbornwithanawarenessofthemselvesasmaleorfemalethisawarenessdevelopsovertimeand,likeall
developmentalprocesses,maybederailedbyachildssubjectiveperceptions,relationships,andadverse
experiencesfrominfancyforward.Peoplewhoidentifyasfeelingliketheoppositesexorsomewherein
betweendonotcompriseathirdsex.Theyremainbiologicalmenorbiologicalwomen.2,3,4
3.Apersonsbeliefthatheorsheissomethingtheyarenotis,atbest,asignofconfusedthinking.Whenan
otherwisehealthybiologicalboybelievesheisagirl,oranotherwisehealthybiologicalgirlbelievessheisaboy,
anobjectivepsychologicalproblemexiststhatliesinthemindnotthebody,anditshouldbetreatedassuch.
Thesechildrensufferfromgenderdysphoria.Genderdysphoria(GD),formerlylistedasGenderIdentityDisorder
(GID),isarecognizedmentaldisorderinthemostrecenteditionoftheDiagnosticandStatisticalManualofthe
AmericanPsychiatricAssociation(DSMV).5ThepsychodynamicandsociallearningtheoriesofGD/GIDhave
neverbeendisproved.2,4,5
4.Pubertyisnotadiseaseandpubertyblockinghormonescanbedangerous.Reversibleornot,puberty
blockinghormonesinduceastateofdiseasetheabsenceofpubertyandinhibitgrowthandfertilityina
previouslybiologicallyhealthychild.6
5.AccordingtotheDSMV,asmanyas98%ofgenderconfusedboysand88%ofgenderconfusedgirls
eventuallyaccepttheirbiologicalsexafternaturallypassingthroughpuberty.5
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6.Childrenwhousepubertyblockerstoimpersonatetheoppositesexwillrequirecrosssexhormonesin
lateadolescence.Crosssexhormones(testosteroneandestrogen)areassociatedwithdangeroushealth
risksincludingbutnotlimitedtohighbloodpressure,bloodclots,strokeandcancer.7,8,9,10
7.Ratesofsuicidearetwentytimesgreateramongadultswhousecrosssexhormonesandundergosex
reassignmentsurgery,eveninSwedenwhichisamongthemostLGBTQaffirmingcountries.11What
compassionateandreasonablepersonwouldcondemnyoungchildrentothisfateknowingthatafterpubertyas
manyas88%ofgirlsand98%ofboyswilleventuallyacceptrealityandachieveastateofmentalandphysical
health?
8.Conditioningchildrenintobelievingthatalifetimeofchemicalandsurgicalimpersonationofthe
oppositesexisnormalandhealthfulischildabuse.Endorsinggenderdiscordanceasnormalviapublic
educationandlegalpolicieswillconfusechildrenandparents,leadingmorechildrentopresenttogender
clinicswheretheywillbegivenpubertyblockingdrugs.This,inturn,virtuallyensuresthattheywillchoosea
lifetimeofcarcinogenicandotherwisetoxiccrosssexhormones,andlikelyconsiderunnecessarysurgical
mutilationoftheirhealthybodypartsasyoungadults.
MichelleA.Cretella,M.D.
PresidentoftheAmericanCollegeofPediatricians
QuentinVanMeter,M.D.
VicePresidentoftheAmericanCollegeofPediatricians
PediatricEndocrinologist
PaulMcHugh,M.D.
UniversityDistinguishedServiceProfessorofPsychiatryatJohnsHopkinsMedicalSchoolandtheformer
psychiatristinchiefatJohnsHopkinsHospital
ForaPDFversionclickhere:GenderIdeologyHarmsChildren.
CLARIFICATIONSinresponsetoquestionsregardingpoints3&5:
RegardingPoint3:WheredoestheAPAorDSMVindicatethatGenderDysphoriaisamentaldisorder?
TheAPA(AmericanPsychiatricAssociation)istheauthoroftheDiagnosticandStatisticalManualofMental
Disorders,5thedition(DSMV).TheAPAstatesthatthosedistressedandimpairedbytheirGDmeetthe
definitionofadisorder.TheCollegeisunawareofanymedicalliteraturethatdocumentsagenderdysphoricchild
seekingpubertyblockinghormoneswhoisnotsignificantlydistressedbythethoughtofpassingthroughthe
normalandhealthfulprocessofpuberty.
FromtheDSMVfactsheet:
Thecriticalelementofgenderdysphoriaisthepresenceofclinicallysignificantdistressassociatedwiththe
condition.
Thisconditioncausesclinicallysignificantdistressorimpairmentinsocial,occupational,orotherimportant
areasoffunctioning.
RegardingPoint5:WheredoestheDSMVlistratesofresolutionforGenderDysphoria?
Onpage455oftheDSMVunderGenderDysphoriawithoutadisorderofsexdevelopmentitstates:Ratesof
persistenceofgenderdysphoriafromchildhoodintoadolescenceoradulthoodvary.Innatalmales,persistence
hasrangedfrom2.2%to30%.Innatalfemales,persistencehasrangedfrom12%to50%.Simplemathallows
onetocalculatethatfornatalboys:resolutionoccursinasmanyas100%2.2%=97.8%(approx.98%of
genderconfusedboys)Similarly,fornatalgirls:resolutionoccursinasmanyas100%12%=88%gender
confusedgirls
Thebottomline:Ouropponentsadvocateanewscientificallybaselessstandardofcareforchildrenwitha
psychologicalcondition(GD)thatwouldotherwiseresolveafterpubertyforthevastmajorityofpatients
concerned.Specifically,theyadvise:affirmationofchildrensthoughtswhicharecontrarytophysicalreality
thechemicalcastrationofthesechildrenpriortopubertywithGnRHagonists(pubertyblockerswhichcause
infertility,stuntedgrowth,lowbonedensity,andanunknownimpactupontheirbraindevelopment),and,finally,
thepermanentsterilizationofthesechildrenpriortoage18viacrosssexhormones.Thereisanobviousself
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fulfillingnaturetoencouragingyoungGDchildrentoimpersonatetheoppositesexandtheninstitutepubertal
suppression.Ifaboywhoquestionswhetherornotheisaboy(whoismeanttogrowintoaman)istreatedasa
girl,thenhashisnaturalpubertalprogressiontomanhoodsuppressed,havewenotsetinmotionaninevitable
outcome?Allofhissamesexpeersdevelopintoyoungmen,hisoppositesexfriendsdevelopintoyoungwomen,
butheremainsaprepubertalboy.Hewillbeleftpsychosociallyisolatedandalone.Hewillbeleftwiththe
psychologicalimpressionthatsomethingiswrong.Hewillbelessabletoidentifywithhissamesexpeersand
beingmale,andthusbemorelikelytoselfidentifyasnonmaleorfemale.Moreover,neurosciencerevealsthat
theprefrontalcortexofthebrainwhichisresponsibleforjudgmentandriskassessmentisnotmatureuntilthe
midtwenties.Neverhasitbeenmorescientificallyclearthatchildrenandadolescentsareincapableofmaking
informeddecisionsregardingpermanent,irreversibleandlifealteringmedicalinterventions.Forthisreason,the
Collegemaintainsitisabusivetopromotethisideology,firstandforemostforthewellbeingofthegender
dysphoricchildrenthemselves,andsecondly,foralloftheirnongenderdiscordantpeers,manyofwhomwill
subsequentlyquestiontheirowngenderidentity,andfaceviolationsoftheirrighttobodilyprivacyandsafety.
PleasevisitthispageontheCollegewebsiteconcerningsexualityandgenderissues.
APDFversionofthispagecanbedownloadedhere:GenderIdeologyHarms
References:
1.ConsortiumontheManagementofDisordersofSexDevelopment,ClinicalGuidelinesfortheManagement
ofDisordersofSexDevelopmentinChildhood.IntersexSocietyofNorthAmerica,March25,2006.Accessed
3/20/16fromhttp://www.dsdguidelines.org/files/clinical.pdf.
2.Zucker,KennethJ.andBradleySusanJ.GenderIdentityandPsychosexualDisorders.FOCUS:TheJournal
ofLifelongLearninginPsychiatry.Vol.III,No.4,Fall2005(598617).
3.Whitehead,NeilW.IsTranssexualitybiologicallydetermined?TripleHelix(UK),Autumn2000,p68.
accessed3/20/16fromhttp://www.mygenes.co.nz/transsexuality.htmseealsoWhitehead,NeilW.TwinStudies
ofTranssexuals[RevealsDiscordance]accessed3/20/16fromhttp://www.mygenes.co.nz/transs_stats.htm.
4.Jeffreys,Sheila.GenderHurts:AFeministAnalysisofthePoliticsofTransgenderism.Routledge,NewYork,
2014(pp.135).
5.AmericanPsychiatricAssociation:DiagnosticandStatisticalManualofMentalDisorders,FifthEdition,
Arlington,VA,AmericanPsychiatricAssociation,2013(451459).Seepage455re:ratesofpersistenceofgender
dysphoria.
6.Hembree,WC,etal.Endocrinetreatmentoftranssexualpersons:anEndocrineSocietyclinicalpractice
guideline.JClinEndocrinolMetab.200994:31323154.
7.OlsonKennedy,JandForcier,M.Overviewofthemanagementofgendernonconformityinchildrenand
adolescents.UpToDateNovember4,2015.Accessed3.20.16fromwww.uptodate.com.
8.Moore,E.,Wisniewski,&Dobs,A.Endocrinetreatmentoftranssexualpeople:Areviewoftreatment
regimens,outcomes,andadverseeffects.TheJournalofEndocrinology&Metabolism,200388(9),pp3467
3473.
9.FDADrugSafetyCommunicationissuedforTestosteroneproductsaccessed3.20.16:
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm161874.htm.
10.WorldHealthOrganizationClassificationofEstrogenasaClassICarcinogen:
http://www.who.int/reproductivehealth/topics/ageing/cocs_hrt_statement.pdf.
11.Dhejne,C,et.al.LongTermFollowUpofTranssexualPersonsUndergoingSexReassignmentSurgery:
CohortStudyinSweden.PLoSONE,20116(2).Affiliation:DepartmentofClinicalNeuroscience,Divisionof
Psychiatry,KarolinskaInstitutet,Stockholm,Sweden.Accessed3.20.16from
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885.

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