OPINION:
The child transgender craze has begun to recede in law and politics, but it is alive and unwell in the powerful medical organizations that shape government policy, medical practice and parents’ perceptions.
The evidence can be found in the responses of 10 prominent medical societies to a simple request we recently made.
In July, we asked organizations including the American Medical Association, the American Academy of Pediatrics and the Endocrine Society to support restrictions on the rarest and most dangerous transgender treatments: genital surgeries on children.
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After nearly two months, none has responded.
We petitioned these societies because of their influence in the transgender debate. All of them support child transgender treatments, generally on the grounds that they are “medically necessary,” “life-saving” or simply a matter for physicians and patients to decide together.
Indeed, such statements are often the first things parents or children find when they search for information about treatments. The societies give the appearance that the debate is settled and the risks nonexistent, and physicians tend to follow their guidelines, assuming they are grounded in the best medical science.
The opposite is true with child transgender treatments, as reviews in the U.S., Britain and other nations have demonstrated.
Still, not all transgender treatments are equal. Puberty blockers and cross-sex hormones have many dangers, such as impaired bone density, possible infertility, cardiovascular disease and metabolic disorders.
Although these effects are significant and can be devastating in their own right, they pale in comparison with those of genital surgeries.
It is one thing for a biological boy to lose bone density after taking puberty blockers. It is something else entirely for his testicles to be surgically removed and his penis to be split down the middle and refashioned into the shape of a vagina — a procedure that necessarily involves castration.
For biological girls, there is a profound difference between the surgical removal of breasts and the removal of the uterus. The former is largely cosmetic — though with significant ramifications, such as future inability to breastfeed — whereas the latter permanently eliminates the patient’s ability to have children.
Genital surgeries are life-changing and potentially life-ruining to an extreme degree.
We strongly support protecting children from all transgender treatments and praise the 27 states that have banned or restricted interventions to “trans” children. Yet genital surgeries are uniquely appalling, both medically and ethically. They destroy a child’s sexual function — a core part of their biological identity — and they do so while children’s brains are still developing.
This raises questions about whether the children can truly consent to such fraught procedures. We restrict voting and drinking to adults for good reason. Why, then, do we allow children to take the monumental step of cutting off their penises or ripping out their ovaries?
Hence, our request to the medical societies. We did not ask them to change their guidelines or recommendations on puberty blockers or cross-sex hormones or even “top” surgeries — just genital surgeries. We appealed to the significantly worse documented dangers of these surgeries, as well as their rarity.
Our organization’s research, supported by data from a JAMA Network Open analysis, found that more than 400 children received genital surgeries from 2016 through 2020. That is a far cry from the 10,000-plus who received hormones and top surgeries from 2019 through 2023.
If relatively fewer children are getting genital surgeries, it should be easier for medical societies to support restricting those procedures to adults.
Yet none of the medical societies responded, much less agreed. To use the language of the social-justice left, their silence is violence. They are endorsing profound physical — and often mental — harm to vulnerable children ages 13 to 17. They are supporting the permanent destruction of these children’s fertility and basic sexual functioning, to say nothing of many other physical issues resulting from complex surgeries.
In short, these 10 medical societies are elevating political ideology over ethical medical practice. If they cannot agree to restrictions on child genital surgeries, there is no limitation on transgender treatments that medical societies will accept.
By giving us the silent treatment, groups such as the American Medical Association, the American Academy of Pediatrics, the Endocrine Society and others have given parents and the broader public reason to completely ignore their voice on child transgenderism.
As Dr. Miceli stated upon sending out our initial letter, these professional societies “bear tremendous responsibility for the harm done to American children.” It appears medical societies wear that harm as a badge of honor.
• Dr. Stanley Goldfarb is board chairman of Do No Harm, where Dr. Kurt Miceli is chief medical officer.
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