The New York Times article "Helping Pediatricians Care for Transgender Children" pitches the American Academy of Pediatrics policy paper on comprehensive care for transgender adolescents
[1,2].
This care includes the most radical and risky of hormone manipulations and surgeries. There is a concept defined called "gender identity" which has no physical presence and apparently can only be made known to the person in which it resides. Comprehensive gender affirmative therapy is a high risk, experimental therapy based on low quality evidence and represents a treatment for a condition which cannot be diagnosed by any doctor.
Consider, if you were told your child had cancer would you expect to see that a tissue sample had been collected and analyzed to prove the diagnosis? If you were told that your child has diabetes would you expect to see blood sugar results that confirm the diagnosis?
In the first example, toxic chemotherapeutics and radiation may be administered and risky surgeries may be performed to treat the cancer. In the second example, a child's blood sugar levels must be monitored very frequently and insulin carefully administered to maintain the delicate balance of blood glucose. Too much insulin may cause severe low glucose levels leading to hospitalization and even death. Too little insulin may lead to placement in an intensive care unit to treat ketoacidosis.
The misdiagnosis of either cancer or diabetes will lead to considerable harm to the child because of unnecessary treatments.Now change the scenario: your pediatrician tells you that your 11-year-old daughter is "gender diverse"
[3]. That your child has a "gender identity" that is a boy. That if treatment is not begun right away there is a good chance that "he" will commit suicide and you will never hold "him" in your arms again.
"I see," you reply gravely, "and what does the treatment entail?"
"Well puberty must be blocked, it is important that 'he' never has a first period. Testosterone must be administered to help with beard growth, changing of the voice and muscle formation. Later, surgery can be done to remove unneeded breast tissue. Eventually, of course, when 'he' sees fit, he can have 'his' ovaries and uterus removed. Through complicated surgeries the flesh of 'his' forearm, including skin and muscle, can be stripped to make a penis".
"Gosh, that all seems rather drastic. This is the first time I'm hearing this about my daughter. This gender diverse or gender identity condition, can you show me the lab work that verifies this? I am very concerned about the side effects of these hormones and complications of surgery."
"Oh no," the pediatrician replies, "there is no blood test for this, it's a 'brain thing'," he says with a ring of condescension.
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