Health & Lifestyle

American Academy of Pediatrics says denying gender affirming care to trans children is ‘CHILD ABUSE’

  • US is an outlier when it comes to allowing medical interventions for trans minors
  • Campaigners abroad argue issue in US is far more political than medicine-based 
  • READ MORE:  Woman lived as a trans man before ‘God’ told her to detransition

America’s leading pediatricians have sparked controversy after suggesting that it is child abuse to deny gender-affirming care to minors. 

The influential American Academy of Pediatrics (AAP) said that ‘withholding [gender-affirming care] is harmful to children and amounts to state-sanctioned medical neglect and emotional abuse.’

The AAP made the claim in a consensus statement published in late December and the declaration was in response to a wave of age restrictions on puberty-blocking drugs and surgeries for children in Republican states.

While its views are not medically binding, the panel is made up of 70,000 of the country’s top child doctors and its recommendations are considered the gold-standard. 

But healthcare experts in other countries have called the AAP’s comments unethical and irresponsible, focusing more on the politics of the moment than medicine. 

views are not medically binding, the panel is made up of 70,000 of the country's top child doctors and its recommendations are considered the gold-standard

views are not medically binding, the panel is made up of 70,000 of the country’s top child doctors and its recommendations are considered the gold-standard

A growing number of states, primarily those led by Republicans, have introduced and enacted a flurry of bills restricting youth access to puberty blockers and hormones

A growing number of states, primarily those led by Republicans, have introduced and enacted a flurry of bills restricting youth access to puberty blockers and hormones

The US has become an outlier among most Western countries when it comes to treating children suffering from gender dysphoria – with the UK, France, Sweden, and a host of other European countries all pausing puberty blocking drugs and surgeries in minors until more is known about their long-term mental and physical effects.

In the US, the issue has become a political lightning rod, with over a dozen Republican states limiting children’s access to transition medicine and promising to punish doctors and patients who allow it. 

Meanwhile, blue states have painted themselves as liberal bastions for LGBTQ individuals by requiring that insurers cover certain services and proving legal protection for people who travel from restrictive states for treatment that has been banned at home.    

AAP’s official journal Pediatrics that argued added that legislative efforts across the country to limit access to that care ‘operate under the guise of protecting children. 

‘In reality, they punish caregivers and physicians when they choose to support children. 

‘They deny children access to routine health care that has been shown to decrease dramatically high rates of suicide and depression for [transgender and gender diverse] youth.’

The AAP has long been a defender of access to transition medicines and surgeries for young people, pointing to preliminary research that suggests in the short-term, it improves the mental health of trans children. 

However, there are fears in the US and other countries that children with depression, eating disorders, and other mental conditions, as well as autism spectrum disorder, are being rushed into transition without digging deeper into psychological symptoms that could explain their feelings of mismatch between their bodies and their sense of self.

There has also been a wave of ‘de-transitioners’ in several Western countries who have come to regret their choice to transition in their younger years, believing doctors failed them by not challenging them as children, leaving them to suffer irreversible physical issues like trouble using the toilet, or having sex.

Bev Jackson, co-founder of the UK-based LGB Alliance, a charity that supports gays, lesbians, and bisexuals but opposes gender-affirming care told DailyMail.com: ‘What worries us particularly is in the US it’s red states vs blue states. 

‘It’s become a highly politicized issue, and the idea of any medical issue becoming politicized is highly alarming because when you’re treating patients, you should care only about the evidence base.’

Jackson added: ‘The worst thing is this is presented as progressive. [If I were an American] I would be a Democrat. But on this issue, the Democrats are very wrong.’

As the US has become increasingly divided on the issue, the UK government paused all puberty blockers for children last year, saying more research is needed into the potential benefits and harms. 

The move has not received significant backlash. It came after an explosive investigation into The Gender Identity Development Service (GIDS) at Tavistock finding that health providers there were wrongly fast-tracking children into changing their gender — with the mental health and social reasons behind their wishes being overlooked. 

Similar pauses have been imposed in Sweden, France, Finland, and Norway.    

The issue of transgender children's access to healthcare  has become a political lightning rod, deepening the divide that separates Democrats and Republicans

The issue of transgender children’s access to healthcare  has become a political lightning rod, deepening the divide that separates Democrats and Republicans

Stephanie Davies-Arai, Director of the UK-based campaign group Transgender Trend, told DailyMail.com: ‘It is irresponsible for any health body to put out guidance on that basis. They cannot say with certainty that this approach is safe, yet they are issuing guidance.

‘We have to remember that this whole gender affirmative approach is not a clinically developed approach. The previous approach for children was waiting and giving some therapeutic help. It is case by case. And that approach was never found to cause harm. There weren’t risks with that approach.’

At least 22 Republican states have enacted restrictions on gender-affirming care for children, with supporters arguing that the objective is to protect children from irreversible medical intervention.

But blue states and cities have taken a hardline against those efforts, and trans rights have become a litmus test for US politicians seeking election in the fall.

Ms Davies-Arai said: ‘Because it’s so politicized, if you question it, you’re labeled as transphobic. So it’s not being looked at as a medical issue; it’s all political. When that happens, all medical ethics go out the window.’

Unlike most European countries where universal healthcare is guaranteed thanks to taxpayer dollars, the US healthcare system is private and run primarily by insurance conglomerates such as Blue Cross Blue Shield and Elevance, which pass down costs to patients.

If they don’t have an insurance policy requiring a monthly premium, they must foot the entire bill themselves.

Not all insurance will cover monthly puberty-blocking shots or hormone therapies, which can cost around $1,200 a pop, making the business of providing gender-affirming care highly lucrative.

‘There’s a lot of money to be made in the US on this,’ Ms Jackson said.

There is also evidence of children undergoing the transition process only to regret it when they get older. 

Prisha Mosley, 24, started taking testosterone aged 17 and had her breasts removed the following year. She regrets her decisions and is raising money to pay for treatment to detransition

Prisha Mosley, 24, started taking testosterone aged 17 and had her breasts removed the following year. She regrets her decisions and is raising money to pay for treatment to detransition   

The young man, known only as Kobe, is pictured here on the left after he decided to stop transitioning and on the right after he made the decision, which he now regrets

The young man, known only as Kobe, is pictured here on the left after he decided to stop transitioning and on the right after he made the decision, which he now regrets

Prisha Mosley, a 24-year-old from Michigan, started taking testosterone aged 17 and had her breasts removed the following year. She has come to regret her decision and is raising funds on GoFundMe to help cover the cost of the detransition process. 

She discovered transgenderism online and started socially transitioning to being a boy aged 15, believing it would help her anorexia, anxiety, depression and other mental health issues. 

Looking back, she says she and her family were emotionally manipulated by the gender specialist who approved her to see a doctor for hormones and a later surgeon for top surgery after only brief consultations.

Doctors may be able to reconstruct her breasts, but it’s unclear whether she’ll be able to conceive children. She has no sensation in her chest and suffers from vaginal atrophy and dryness, which makes intercourse painful. 

A detransitioning woman from Maryland named Cassie who had a mastectomy at age 14 later said that therapists she met with beforehand insisted the surgery was the ‘only solution’ to her mental health issues – despite her also struggling with bipolar disorder, autism, and sexual assault trauma. 

She also claimed that her doctor encouraged her to get the procedure done after only one visit and regretted the decision almost immediately after the surgery. She has branded it as ‘medical malpractice’ that professionals didn’t take more time to go over the long-term effects and potential consequences beforehand.

Meanwhile, an American named Kobe who began puberty blockers at 13 and had his testicles removed at 19, said he bitterly regrets his decision to transition and was told to ‘play the suicide card’ by older trans people in order to receive treatment. 

He now suffers from severe spinal pain he fears could be osteoporosis, with puberty blockers linked to bone injuries. 

There are signs that the US is slowing down on its push to make transition medicine available to young adolescents just as the UK’s National Health Service did following a review of Tavistock gender clinic that found children were being referred for medical treatment prematurely and in surging numbers.

Vanderbilt University froze all gender-affirming care for children in 2022 after a specialist at the hospital was found touting transition surgeries as ‘huge money makers’ for their boss.

Between 2009 and 2019, the number of teens seeking transitional treatment increased 1,000 percent in biological males, and 4,400 percent in females.

In the US, the numbers of youths identifying as transgender has nearly doubled since 2017, according to the Centers for Disease Control and Prevention.

Ms Davies-Arai said: ‘A child is on the path to being a lifelong medical patient. Whether they carry on or not, if they detransition, you can’t just stop. You will still have to be monitored for life, and you still have to work out which hormones to take.’ 


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