Gender dysphoria: health professionals call for more attention to children's mental health in this situation
New statement warns of long-term risks of gender-affirming interventions More than 100 health professionals and medical groups have signed a statement calling for a shift in focus towards addressing the underlying psychological problems found in children who feel uncomfortable with their gender.
The Doctors Protecting Children declaration was released by pediatricians, physicians, researchers, medical ethics advocates and faith-based medical groups on June 6 at a press conference in Washington.
Developed by the American College of Pediatricians (ACPeds), the statement emphasizes the long-term risks of "gender-affirming" interventions for children with gender dysphoria. This type of intervention involves a "social transition" such as changing one's name and appearance to align with the preferred gender, as well as the use of puberty blockers, opposite-sex hormones, and genital surgeries.
Instead, psychotherapy for underlying mental health conditions such as depression, autism, anxiety, and emotional trauma should be the "first line of treatment" for children who are confused or anxious about their gender, according to the statement.
"We are here to challenge the claims of these American medical organizations that those of us who are concerned are a minority and that their protocols reflect the general will," said Dr. Jill Simmons, pediatrician and executive director of ACPeds, at the event. "This is not a consensus and we speak with a strong and united voice: Enough!"
Dr. Simmons was referring to protocols developed by the World Professional Association for Transgender Health (WPATH), an international non-profit group dedicated to the study of transgender health.
The WPATH guidelines, known as the Standard of Care 8, recommend that adolescent patients diagnosed with "gender dysphoria" have access to puberty blockers, opposite-sex hormones, and surgeries, as long as they can demonstrate "the emotional and cognitive maturity required to give informed consent to treatment."
However, videos and internal documents, recently leaked, appear to show that some members of WPATH questioned whether children were able to understand all the procedures and ramifications of these drugs.
Dr. Andre Van Mol, a Navy veteran turned family physician and adolescent sexuality expert at ACPeds, echoed these concerns.
"Minors cannot give truly informed consent," he said at the June 4 rally, speaking on behalf of ACPeds, the Christian Medical and Dental Association, and the American Academy of Medical Ethics. "Children have developing and immature brains, they often change their minds, they are willing to take risks, they are vulnerable to peer pressure, and they don't understand the long-term consequences."
In terms of relevant approaches to treating children who feel uncomfortable with their gender, Dr. Van Mol spoke in favor of the traditional "desistance" method, saying that in most cases, these feelings will go away on their own during the normal developmental process of puberty.
"The natural course of gender dysphoria is dropping out of adulthood in 85 percent of cases, unless confirmed," the doctor said, citing figures from a 2021 study on dropout among boys with gender identity issues.
"The likelihood of desistance and underlying mental health and other issues is why watchful waiting, coupled with mental health assessment and counselling for the patient and family, has been and is, increasingly, recognised as the standard of care for minors with gender dysphoria," he added.
Emphasizing the importance of focusing on identifying and treating the patient's underlying psychological issues, Dr. Van Mol urges healthcare providers to look for "mental health alternatives" rather than gender transition.
"The affirmation of the transition (...) does not reduce the number of suicides," he said. "It doesn't fix mental health issues or trauma."
"There are good mental health alternatives to gender-affirming health care that address underlying issues instead of dodging them," the family physician added. "There is always a more honest way to deal with gender confusion than chemical sterilization and surgical mutilation of young, healthy bodies."
The June 4 statement also notes that several European countries have suspended transgender medical interventions for children and, citing caution, are instead focusing on treating underlying mental health issues.
Sweden, for example, decided in 2022 to restrict hormone therapy for children, except in very rare cases, and decided that mastectomies – the surgical removal of one or both breasts – for teenage girls wishing to transition could only be done in a research setting. More recently, in April, the Scottish health authorities suspended the prescription of puberty blockers to new patients under the age of 18.
The statement urges medical organizations in the United States to do the same and "immediately cease" promoting WPATH protocols.
She says, "We also encourage physicians who are members of these professional organizations to reach out to their leaders and encourage them to practice the evidence-based research that is currently available."
The Doctors Protecting Children declaration was released by pediatricians, physicians, researchers, medical ethics advocates and faith-based medical groups on June 6 at a press conference in Washington.
Developed by the American College of Pediatricians (ACPeds), the statement emphasizes the long-term risks of "gender-affirming" interventions for children with gender dysphoria. This type of intervention involves a "social transition" such as changing one's name and appearance to align with the preferred gender, as well as the use of puberty blockers, opposite-sex hormones, and genital surgeries.
Instead, psychotherapy for underlying mental health conditions such as depression, autism, anxiety, and emotional trauma should be the "first line of treatment" for children who are confused or anxious about their gender, according to the statement.
"We are here to challenge the claims of these American medical organizations that those of us who are concerned are a minority and that their protocols reflect the general will," said Dr. Jill Simmons, pediatrician and executive director of ACPeds, at the event. "This is not a consensus and we speak with a strong and united voice: Enough!"
Dr. Simmons was referring to protocols developed by the World Professional Association for Transgender Health (WPATH), an international non-profit group dedicated to the study of transgender health.
The WPATH guidelines, known as the Standard of Care 8, recommend that adolescent patients diagnosed with "gender dysphoria" have access to puberty blockers, opposite-sex hormones, and surgeries, as long as they can demonstrate "the emotional and cognitive maturity required to give informed consent to treatment."
However, videos and internal documents, recently leaked, appear to show that some members of WPATH questioned whether children were able to understand all the procedures and ramifications of these drugs.
Dr. Andre Van Mol, a Navy veteran turned family physician and adolescent sexuality expert at ACPeds, echoed these concerns.
"Minors cannot give truly informed consent," he said at the June 4 rally, speaking on behalf of ACPeds, the Christian Medical and Dental Association, and the American Academy of Medical Ethics. "Children have developing and immature brains, they often change their minds, they are willing to take risks, they are vulnerable to peer pressure, and they don't understand the long-term consequences."
In terms of relevant approaches to treating children who feel uncomfortable with their gender, Dr. Van Mol spoke in favor of the traditional "desistance" method, saying that in most cases, these feelings will go away on their own during the normal developmental process of puberty.
"The natural course of gender dysphoria is dropping out of adulthood in 85 percent of cases, unless confirmed," the doctor said, citing figures from a 2021 study on dropout among boys with gender identity issues.
"The likelihood of desistance and underlying mental health and other issues is why watchful waiting, coupled with mental health assessment and counselling for the patient and family, has been and is, increasingly, recognised as the standard of care for minors with gender dysphoria," he added.
Emphasizing the importance of focusing on identifying and treating the patient's underlying psychological issues, Dr. Van Mol urges healthcare providers to look for "mental health alternatives" rather than gender transition.
"The affirmation of the transition (...) does not reduce the number of suicides," he said. "It doesn't fix mental health issues or trauma."
"There are good mental health alternatives to gender-affirming health care that address underlying issues instead of dodging them," the family physician added. "There is always a more honest way to deal with gender confusion than chemical sterilization and surgical mutilation of young, healthy bodies."
The June 4 statement also notes that several European countries have suspended transgender medical interventions for children and, citing caution, are instead focusing on treating underlying mental health issues.
Sweden, for example, decided in 2022 to restrict hormone therapy for children, except in very rare cases, and decided that mastectomies – the surgical removal of one or both breasts – for teenage girls wishing to transition could only be done in a research setting. More recently, in April, the Scottish health authorities suspended the prescription of puberty blockers to new patients under the age of 18.
The statement urges medical organizations in the United States to do the same and "immediately cease" promoting WPATH protocols.
She says, "We also encourage physicians who are members of these professional organizations to reach out to their leaders and encourage them to practice the evidence-based research that is currently available."