Many doctors share our concerns
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.
Agree entirely with those who question the wisdom of using puberty blockers on children, and your comments upon the madness of what is going on. This is so obviously interfering in natural processes and social development that should be left to run their course without intervention that I simply cannot understand why it is done, let alone why so many seem to be convinced that it must be done.
If children cannot make reasonable decisions about the uses of sexuality without harm to their development before they are 18, then how is it possible for reasonable decisions to be made about “gender identity” (whatever that is supposed to mean) when they have not even entered puberty?
The whole thing is a kind of social madness. It is time for people to begin rethinking what it means to think! I share very few of Danielle Smith’s political convictions, but I agree that this is something that needs to be stopped, and the Federal Government should begin taking the harms being done seriously and legislating for the whole country. Asking kids to make decisions of such moment for their future is absurd, and letting physicians make such decisions for them is madness.
Doctor’s groups aren’t the same thing as patients’ groups, though. And doctors’ groups aren’t even the same thing as groups of doctors. Doctors’ groups are special interest bureaucracies, and the policies they advocate are not always in line with the interests of the patients at the receiving end of their respective fields of medicine, and they’re often not even in line with the majority of doctors working in the fields they purport to represent. Doctors’ interests diverge from patients’ interests all the time. That’s why medical scandals keep happening. And doctors’ groups’ interests diverge also from doctors’ interests, because the doctors they purport to represent are often too busy treating their patients to rigorously vet all the various policies the groups endorse, and the groups themselves are made up of office busybodies with plently of time to get persuaded by pharmaceutical lobbies or other parties with financial interests.
It’s lazy journalism to assume doctors’ groups speak for all doctors, just like it’s lazy journalism to let supposed gay rights lobbies like GLAAD, HRC & Stonewall UK speak for all gays & lesbians.
They want company. And clout. And most of all, they want cover. Some adults who engage in unreasonable behaviours and make unreasonable demands want the veneer of legitemacy that comes with associating their behaviour with vulnerable children born special.
And other adults with obvious mental health conditions have made bad decisions they can’t undo. This group, trapped by the sunk cost fallacy and haunted by the truth seeping in through the cracks, are seeking solace by vicariously convincing others that “transness” is an innate state and that going ahead with transition is never a mistake.
It’s such a terrible psychological flaw in humans, our capacity to do great harm to others rather than admit that we made mistakes and harmed ourselves.
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