Mutilating Children

What is going on at the American Academy of Pediatrics? That august professional guild had previously been one of the few remaining in the world that supported child mutilation as treatment for gender dysphoria.

Now, seeing the problems caused by childhood obesity, the same organization is proposing medication and surgery as the proper treatment.

Apparently, the AAP has chosen to ignore lifestyle and psychological problems-- and to promote better living through surgery.

As the world discovers that transgender identification is a social contagion, the Academy has decided that such is not the case. The Wall Street Journal reported:

A spate of headlines this month declared that America’s surge in transgender identification wasn’t being caused by a social contagion. These articles were prompted by a new study by Jack Turban and colleagues in Pediatrics, flagship journal of the American Academy of Pediatrics. The study claimed that social influence isn’t the reason that as many as 9% of America’s youth now call themselves transgender. Thus, Dr. Turban argues, efforts in conservative states to regulate on-demand puberty blockers, cross-sex hormones and surgery must be resisted.

Yet Dr. Turban’s study is deeply flawed and likely couldn’t have survived a reasonable peer-review process. The swift response from the scientific community made both points clear—with even those who support hormones and surgery for gender-dysphoric youth noting that Dr. Turban’s shoddy science undermined their cause.

Nevertheless, the media have promoted his work as a refutation of the claim that the wildfire spread of transgender identity is an example of social contagion—a phenomenon in which members of a group (mostly young and female) mutually influence one another’s emotions and behavior.

Why did Turban reject the notion of social contagion?

The Turban study rejects the social-contagion theory on the grounds that more biological boys than girls identified as trans in 2017 and 2019, according to data collected from 19 states by the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey. But the researchers who helped design the CDC questionnaire explicitly warned that youths who identify as transgender may list their sex as their gender identity, making it impossible to discern who is male-to-female or female-to-male (a limitation Dr. Turban has acknowledged in the past).

Countries around the world have come to their senses. In America the august journal of pediatrics continues to insist on mutilating children:

The AAP has ignored the evidence that has led Sweden, Finland and most recently the U.K. to place severe restrictions on medical transition for minors. The largest pediatric gender clinic in the world, the U.K.’s Gender Identity Development Service, was ordered to shut down in July after an independent review expressed concerns about clinicians rushing minors to medical transition. Medical societies in France, Belgium and Australia have also sounded the alarm. The U.S. is an outlier on pediatric gender medicine.

The AAP has stifled debate on how best to treat youth in distress over their bodies, shut down efforts by critics to present better scientific approaches at conferences, used technicalities to suppress resolutions to bring it into line with better-informed European countries, and put its thumb on the scale at Pediatrics in favor of a shoddy but politically correct research agenda. Its preference for fashionable political positions over evidence-based medicine is a disservice to member physicians, parents and children.

Now, the AAP has weighed in on the question of childhood obesity. Having identified the problem, it has downplayed the importance of diet and exercise and even family dynamics. It has promoted medication and surgery-- for prepubescent children:

NPR reports:

After this intensive therapy, weight loss drugs should be considered for adolescents as young as 12, the AAP says, while teens 13 and older with severe obesity should be evaluated for weight loss surgery.

The more than 14.4 million children who live with obesity face pervasive, harsh and unfair stigma, often even from doctors who are supposed to treat them. The AAP guidelines call for a "whole child" approach, acknowledging that obesity has complex causes including genetics and socioeconomic status rather than personal choices and emphasizing communication that is nonstigmatizing and supportive.

So, the fault does not lie with a child or with the child’s parents. The fault lies with biology and the preferred treatment now involves potentially dangerous surgery and medication.