Two doctors write in The National Post [Canada]:
Alberta Premier Danielle Smith’s recently announced policies on restricting transgender medical interventions for minors have generated much outrage, notwithstanding a subsequent Leger poll that suggested more Canadians than not agree with her proscriptions.
Doctor groups like the Alberta Medical Association (AMA) and the Canadian Pediatric Society (CPS) came out swinging, each issuing strongly worded statements expressing grave concerns. Dr. Sam Wong, head of the AMA’s pediatrics section, argued that “this is poor legislation that is targeting a small percentage of population that has already been targeted by society … and the government is piling on.”
But maybe, just maybe, it’s not “targeting” people to protect them from damaging physical interventions.
The general public could be forgiven for concluding that doctors are collectively of one opinion on this issue. But that’s an illusion: the AMA and the CPS do not speak for all of us. There is no medical consensus on transgender medical interventions for minors.
It’s impossible to know what percentage of physicians agree with Alberta’s premier, given the high professional cost of speaking up. But as physicians who have spoken out publicly with our misgivings around youth gender transition, we can say that many doctors share our concerns. They approach us privately, both in person and electronically, to voice as much. But they shy away from offering public support because of fear of condemnation and career harm.
And maybe, just maybe, it’s not such a great idea to make it taboo to share medical concerns about a medical intervention.
One reason for the taboo, they explain, is the threat of suicide…but how real is the threat?
Fact: There is no evidence for increased suicidality in kids with gender dysphoria once one corrects for psychiatric co-morbidities. A just-published Finnish study in BMJ Mental Health, for instance, which studied more than 2,000 gender-dysphoric youth and compared them to 16,000 matched controls, concluded that clinical gender dysphoria is not predictive of suicide.
Well, ok, but the kids will yell a lot and the parents don’t want to hear it. That’s a good enough reason, right?
As for puberty blockers themselves, Dr. Wong et al. simply sweep aside legitimate concerns over the use of these drugs in physiologically normal children. Hormonal suppression of puberty may permanently alter neurodevelopment, sexual function, and bone development.
Moreover, pubertal suppression may alter the course of gender identity development — essentially cementing into place a gender identity that might otherwise have reconciled with biological sex during the natural course of puberty. Over 95 per cent of youth treated with puberty-blocking GnRH analogs go on to receive cross-sex hormones, whereas up to 95 per cent of those managed with psychological support alone desist from their dysphoric state during puberty.
And maybe that’s the real reason for the intense pressure. People who have already transed want company. It’s not for the benefit of the potential trans kids, it’s for the benefit of the people marooned on the other shore.
That would be an understandable motivation, but also a horrible one.
Finnish physician Dr. Riittakerttu Kaltiala, one of the architects of Finland’s youth gender transition program, has done a U-turn in light of growing evidence of the program’s harm. She now says that just as with the recovered memories of sexual abuse craze of 30 years ago, “Gender transition has gotten out of hand. When medical professionals start saying they have one answer that applies everywhere, or that they have a cure for all life’s pains, that should be a warning to all of us that something has gone very wrong.”
Remember the recovered memories fad? That relied on a wildly naive and credulous idea of how memories work? Now the trick is to be wildly naive and credulous about the meaning of “identity.”
And just two weeks ago the European Academy of Pediatrics issued a statement urging caution, stating that puberty blockers “may irrevocably lead to the use of trans-sex hormones and surgical transition, so it may arguably compromise rather than facilitate freedom of choice.”
I think that’s often the whole point. “Activists” long to compromise freedom of choice in this area, they long to lock people into the Trans Life for the duration.
All of this flies directly in the face of the professed certainty of Dr. Wong and the AMA that the benefits of youth gender transition outweigh the harms. It should raise grave questions as to why the “affirmation” model continues to be the standard of care in Canada.
I think I can safely say that part of the reason, maybe much of it, is the ferocious bullying meted out to dissenters.