Health
US plastic surgeons’ group challenges ‘consensus’ on ‘gender transitions’ for minors
From LifeSiteNews
The American Society of Plastic Surgeons argued that ‘genital surgical interventions’ have not been proven an effective solution to adolescent gender dysphoria, adding that current ‘research’ backing medical intervention is of ‘low quality/low certainty.’
One of the most effective weapons that proponents of radical gender ideology have wielded in support of their cause has been “consensus.”
When pressed to explain how blocking a young boy’s puberty or removing a teenage girl’s healthy breasts provide any medical or mental benefit, they often cite “experts” or refer to a “consensus” of medical organizations and government agencies.
But there’s a problem with that strategy.
Recent research has shown the glaring flaws in the argument that transition drugs and procedures are appropriate or helpful for minors. European countries that had once embraced “gender affirming care” for minors, including the U.K., have begun to reverse these policies.
While American medical organizations and governments have been slow to respond, recent developments indicate that may be changing.
Earlier this year, City Journal reported that the American Society of Plastic Surgeons (ASPS) had not signed on to “any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.”
ASPS added that there is “considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions” and that “the existing evidence base is viewed as low quality/low certainty.”
More recently, the president of that organization, Dr. Steven Williams, told a local media outlet, “I don’t perform gender-affirming care in adolescents, and the reason why is because I don’t think the data supports it.”
“So at my practice, we don’t even entertain that.”
Prominent plastic surgeon Dr. Sheila Nazarian echoed that sentiment. “I think some physicians and some medical associations have been overtaken by a vocal minority and they are politicized,” she said. “This is 100 percent an American political issue. If we look at Europe, very progressive governments have backed off of these procedures in minors because they’re just analyzing the data – as we should with every procedure. Why is it that for this procedure, in this patient population, we just have to shut up?”
In addition, whistleblowers have come forward to reveal the damage being done to children. Evidence now shows that the World Professional Association for Transgender Health (WPATH) has exerted pressure on researchers. In fact, leaked files from WPATH show that some doctors understood many of the concerns about pushing such drugs and procedures on minors – but did so anyway.
A landmark review of the available research on the effect of these drugs and procedures by Dr. Hilary Cass “demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.”
The Cass review, commissioned by the U.K. National Health Service, noted that “[t]he strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate.”
In short, the “consensus” that our media, doctors, activists, and politicians rely upon is no consensus at all. It’s based not on proven science but on a commitment to ideology.
These cracks in the façade that advocates of gender ideology use as a shield provide hope to those who have long been advocating for the truth – in the courtroom and in the culture:
- The truth that no amount of cross-sex hormones or permanently damaging surgery can change a person’s sex.
- The truth that doctors have a duty to “do no harm,” and that includes being honest with patients about the facts regarding procedures that are mischaracterized as “gender affirming.”
It’s heartening to see prominent doctors from at least one major medical association speak the truth about the harm being done to so many children.
In the wake of Donald Trump’s election, we are hopeful that the new administration will follow through on promises to protect boys and girls from gender ideology.
And the issue of gender transition efforts for children has reached the U.S. Supreme Court too. On December 4, the court heard arguments in United States of America v. Skrmetti, in which the state of Tennessee is defending its law protecting children from these harmful and unnecessary procedures.
But we know that regardless of what happens in Washington, D.C., we will continue to face challenges in statehouses, government agencies, and school districts across the country.
The fight for truth isn’t over yet – but this is a big step toward achieving a lasting victory.
Reprinted with permission from the Alliance Defending Freedom.
Health
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The Canadian Medical Association’s inexplicable stance on pediatric gender medicine
By Dr. J. Edward Les
The thalidomide saga is particularly instructive: Canada was the last developed country to pull thalidomide from its shelves — three months during which babies continued to be born in this country with absent or deformed limbs
Physicians have a duty to put forward the best possible evidence, not ideology, based treatments
Late last month, the Canadian Medical Association (CMA) announced that it, along with three Alberta doctors, had filed a constitutional challenge to Alberta’s Bill 26 “to protect the relationship between patients, their families and doctors when it comes to making treatment decisions.”
Bill 26, which became law last December, prohibits doctors in the province from prescribing puberty blockers and hormone therapies for those under 16; it also bans doctors from performing gender-reassignment surgeries on minors (those under 18).
The unprecedented CMA action follows its strongly worded response in February 2024 to Alberta’s (at the time) proposed legislation:
“The CMA is deeply concerned about any government proposal that restricts access to evidence-based medical care, including the Alberta government’s proposed restrictions on gender-affirming treatments for pediatric transgender patients.”
But here’s the problem with that statement, and with the CMA’s position: the evidence supporting the “gender affirmation” model of care — which propels minors onto puberty blockers, cross-gender hormones, and in some cases, surgery — is essentially non-existent. That’s why the United Kingdom’s Conservative government, in the aftermath of the exhaustive four-year-long Cass Review, which laid bare the lack of evidence for that model, and which shone a light on the deeply troubling potential for the model’s irreversible harm to youth, initiated a temporary ban on puberty blockers — a ban made permanent last December by the subsequent Labour government. And that’s why other European jurisdictions like Finland and Sweden, after reviews of gender affirming care practices in their countries, have similarly slammed the brakes on the administration of puberty blockers and cross-gender hormones to minors.
It’s not only the Europeans who have raised concerns. The alarm bells are ringing loudly within our own borders: earlier this year, a group at McMaster University, headed by none other than Dr. Gordon Guyatt, one of the founding gurus of the “evidence-based care” construct that rightfully underpins modern medical practice, issued a pair of exhaustive systematic reviews and meta analyses that cast grave doubts on the wisdom of prescribing these drugs to youth.
And yet, the CMA purports to be “deeply concerned about any government proposal that restricts access to evidence-based medical care,” which begs the obvious question: Where, exactly, is the evidence for the benefits of the “gender affirming” model of care? The answer is that it’s scant at best. Worse, the evidence that does exist, points, on balance, to infliction of harm, rather than provision of benefit.
CMA President Joss Reimer, in the group’s announcement of the organization’s legal action, said:
“Medicine is a calling. Doctors pursue it because they are compelled to care for and promote the well-being of patients. When a government bans specific treatments, it interferes with a doctor’s ability to empower patients to choose the best care possible.”
Indeed, we physicians have a sacred duty to pursue the well-being of our patients. But that means that we should be putting forward the best possible treatments based on actual evidence.
When Dr. Reimer states that a government that bans specific treatments is interfering with medical care, she displays a woeful ignorance of medical history. Because doctors don’t always get things right: look to the sad narratives of frontal lobotomies, the oxycontin crisis, thalidomide, to name a few.
The thalidomide saga is particularly instructive: it illustrates what happens when a government drags its heels on necessary action. Canada was the last developed country to pull thalidomide, given to pregnant women for morning sickness, from its shelves, three months after it had been banned everywhere else — three months during which babies continued to be born in this country with absent or deformed limbs, along with other severe anomalies. It’s a shameful chapter in our medical past, but it pales in comparison to the astonishing intransigence our medical leaders have displayed — and continue to display — on the youth gender care file.
A final note (prompted by thalidomide’s history), to speak to a significant quibble I have with Alberta’s Bill 26 legislation: as much as I admire Premier Danielle Smith’s courage in bringing it forward, the law contains a loophole allowing minors already on puberty blockers and cross-gender hormones to continue to take them. Imagine if, after it was removed from the shelves in 1962, government had allowed pregnant women already on the drug to continue to take thalidomide. Would that have made any sense? Of course not. And the same applies to puberty blockers and cross-gender hormones: they should be banned outright for all youth.
That argument is the kind our medical associations should be making — and would be making, if they weren’t so firmly in the grasp, seemingly, of ideologues who have abandoned evidence-based medical care for our youth.
J. Edward Les is a Calgary pediatrician, a senior fellow with the Aristotle Foundation for Public Policy, and co-author of “Teenagers, Children, and Gender Transition Policy: A Comparison of Transgender Medical Policy for Minors in Canada, the United States, and Europe.”
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