Sun, 09 Jun 2024 12:31
Home pete@sockemwebsolutions.com 2024-06-09T01:33:10+00:00 '' Therefore, given the recent research and the revelations of the harmful approach advocated by WPATH and its followers in the United States, we, the undersigned, call upon the medical professional organizations of the United States, including the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to follow the science and their European professional colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex. Instead, these organizations should recommend comprehensive evaluations and therapies aimed at identifying and addressing underlying psychological co-morbidities and neurodiversity that often predispose to and accompany gender dysphoria. We also encourage the physicians who are members of these professional organizations to contact their leadership and urge them to adhere to the evidence-based research now available.''
Who We Are
As physicians, together with nurses, psychotherapists and behavioral health clinicians, other health professionals, scientists, researchers, and public health and policy professionals, we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex.
Doctors Protecting Children Declaration
As physicians, together with nurses, psychotherapists and behavioral health clinicians, other health professionals, scientists, researchers, and public health and policy professionals, we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex.
We affirm:
Sex is a dimorphic, innate trait defined in relation to an organism's biological role in reproduction. In humans, primary sex determination occurs at fertilization and is directed by a complement of sex determining genes on the X and Y chromosomes. This genetic signature is present in every nucleated somatic cell in the body and is not altered by drugs or surgical interventionsConsideration of these innate differences is critical to the practice of good medicine and to the development of sound public policy for children and adults alike.Gender ideology, the view that sex (male and female) is inadequate and that humans need to be further categorized based on an individual's thoughts and feelings described as ''gender identity'' or ''gender expression'', does not accommodate the reality of these innate sex differences. This leads to the inaccurate view that children can be born in the wrong body. Gender ideology seeks to affirm thoughts, feelings and beliefs, with puberty blockers, hormones, and surgeries that harm healthy bodies, rather than affirm biological reality.Medical decision making should not be based upon an individual's thoughts and feelings, as in ''gender identity'' or ''gender expression'', but rather should be based upon an individual's biological sex. Medical decision making should respect biological reality and the dignity of the person by compassionately addressing the whole person.We recognize:
Most children and adolescents whose thoughts and feelings do not align with their biological sex will resolve those mental incongruencies after experiencing the normal developmental process of puberty.Desistance is the norm without affirmation as documented by Zucker in his article ''The Myth of Peristence''. (1)Zucker, KJ. The myth of persistence: Response to ''A critical commentary on follow-up studies and 'desistance' theories about transgender and gender nonconforming children'' by Temple Newhook et al. International Journal of Transgenderism. 2018: 19(2), 231''245. Published online May 29, 2018.http://doi.org/10.1080/15532739.2018.1468293 [1]In the ''largest sample to date of boys clinic-referred for gender dysphoria,'' there was a desistance rate of 87.8%. (2)Singh D, Bradley SJ and Zucker KJ. A Follow-Up Study of Boys With Gender Identity Disorder. Front Psychiatry. 2021;12:632784. doi: 10.3389/fpsyt.2021.632784The pro-affirmation Endocrine Society Guidelines (2017) admit: '''...the GD/gender incongruence of a minority of prepubertal children appears to persist in adolescence.'' (3)Hembree, W., Cohen-Kettenis PT, Gooren L, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline J Clin Endocrinol Metab. 2017; 102:1''35.A longitudinal study from the University of Groningen in the Netherlands followed 2772 adolescents (recruited from a psychiatric clinic) from age 11 years through 22 '' 26 years. ''In early adolescence 11% of participants reported gender non- contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26).'' Even in this psychiatric patient study group for which interventions were not addressed, but ''gender affirmation'' is most likely, gender non-contentedness (essentially gender noncongruence) decreased substantially from early adolescence to young adulthood.(4)Rawee P, Rosmalen JGM, Kalverdiijk L and Burke SM. Development of gender non-contentedness during adolescence and early adulthood. Archives of Sexual Behavior. 2024; https://doi.org/10.1007/s10508-024-02817-5Responsible informed consent is not possible in light of extremely limited long-term follow-up studies of interventions, and the immature, often impulsive, nature of the adolescent brain. The adolescent brain's prefrontal cortex is immature and is limited in its ability to strategize, problem solve and make emotionally laden decisions that have life-long consequences.[2]Sex-trait modification or ''Gender affirming'' clinics in the United States base their treatments upon the ''Standards of Care'' developed by the World Professional Association for Transgender Health (WPATH). However, the foundation of WPATH guidelines is demonstrably flawed and pediatric patients can be harmed when subjected to those protocols.The two Dutch studies that form the foundation for treatment guidelines as documented in the WPATH ''Standards of Care'' guidelines version 7 (SOC 7) had serious flaws.[3]These studies did show that the appearance of secondary sex characteristics in adolescents and young adults could be changed by hormonal and surgical interventions, but they failed to demonstrate meaningful long-term improvement in psychological well-being.Scientific concerns with these studies also include a lack of a control group, small sample sizes, significant numbers of patients lost to follow up, and the elimination of patients who experienced significant mental illness from entering the studies.It is concerning that the Dutch studies did not address complications and adverse outcome in the adolescent cohort that underwent transition. These complications included new onset diabetes, obesity and one death.[4]There is now sufficient research to further demonstrate the failure of the WPATH, American Academy of Pediatrics and Endocrine Society protocols.The Cass Review was released on April 10, 2024, as an ''independent review of gender identity services for children and young people''. The following points are from Cass's final report:[5]Commissioned by the National Health Service (NHS) England, and chaired by Dr. Hilary Cass, the 388-page report utilized systematic reviews, qualitative and quantitative research, as well as focus groups, roundtables and interviews with international clinicians and policy makers.As part of the evaluation, they reviewed the research on social transition, puberty blockers, and cross-sex hormones.Social transition''The systematic review showed no clear evidence that social transition in childhood has any positive or negative mental health outcomes, and relatively weak evidence for any effect in adolescence.However, those who had socially transitioned at an earlier age and/or prior to being seen in clinic were more likely to proceed to a medical pathway.''Puberty blockers''The systematic review undertaken by the University of York found multiple studies demonstrating that puberty blockers exert their intended effect in suppressing puberty, and also that bone density is compromised during puberty suppression. However, no changes in gender dysphoria or body satisfaction were demonstrated [emphasis added].''''There was insufficient/inconsistent evidence about the effects of puberty suppression on psychological or psychosocial wellbeing, cognitive development, cardio-metabolic risk or fertility.''''Moreover, given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinizing/ feminizing hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.''Cross-sex hormones''The University of York carried out a systematic review of outcomes of masculinising/feminising hormones.'' They concluded, ''There is a lack of high-quality research assessing the outcomes of hormone interventions in adolescents with gender dysphoria/incongruence, and few studies that undertake long-term follow-up. No conclusions can be drawn about the effect on gender dysphoria, body satisfaction, psychosocial health, cognitive development, or fertility.''''Uncertainty remains about the outcomes for height/growth, cardio-metabolic and bone health.''The Cass Review further stated, ''Assessing whether a hormone pathway is indicated is challenging. A formal diagnosis of gender dysphoria is frequently cited as a prerequisite for accessing hormone treatment. However, it is not reliably predictive of whether that young person will have longstanding gender incongruence in the future, or whether medical intervention will be the best option for them.''A 2024 German systematic review on the evidence for use of puberty blockers (PB) and cross-sex hormones (CSH) in minors with gender dysphoria (GD) also found ''The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn't suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD.''[6] There are serious long-term risks associated with the use of social transition, puberty blockers, masculinizing or feminizing hormones, and surgeries, not the least of which is potential sterility.Youth who are socially affirmed are more likely to progress to using puberty blockers and cross-sex (masculinizing or feminizing) hormones.''Social transition is associated with the persistence of gender dysphoria as a child progresses into adolescence.''[7]''Gender social transition of prepubertal children will increase dramatically the rate of gender dysphoria persistence when compared to follow-up studies of children with gender dysphoria who did not receive this type of psychosocial intervention and, oddly enough, might be characterized as iatrogenic.''[8]Puberty blockers permanently disrupt physical, cognitive, emotional and social development.Side effects listed in the Lupron package insert include emotional lability, worsening psychological illness, low bone density, impaired memory, and the rare side-effect of pseudotumor cerebri (brain swelling).[9]A coalition of physicians and medical organizations from around the world submitted a petition to the Commissioner of the U.S. Food and Drug Administration requesting urgent action be taken to eliminate the off-label use of GnRH (growth hormone) agonists in children.[10]Testosterone use in females and estrogen use in males are associated with dangerous health risks across the lifespan including, but not limited to, cardiovascular disease, high blood pressure, heart attacks, blood clots, stroke, diabetes, and cancer.[xi],[12]Genital surgeries affect future fertility and reproduction.A report from Environmental Progress released on March 4, 2024, entitled ''The WPATH Files'' revealed ''widespread medical malpractice on children and vulnerable adults at global transgender healthcare authority.''[13]''The WPATH Files reveal that the organization does not meet the standards of evidence-based medicine, and members frequently discuss improvising treatments as they go along.''''Members are fully aware that children and adolescents cannot comprehend the lifelong consequences of 'gender-affirming care' and, in some cases due to poor health literacy, neither can their parents.''In addition, developmentally challenged and mentally ill individuals were being encouraged to ''transition'', and treatments were often improvised.Evidence-based medical research now demonstrates there is little to no benefit from any or all suggested ''gender affirming'' interventions for adolescents experiencing Gender Dysphoria. Social ''affirmation'', puberty blockers, masculinizing or feminizing hormones, and surgeries, individually or in combination, do not appear to improve long-term mental health of the adolescents, including suicide risk.[14]Psychotherapy for underlying mental health issues such as depression, anxiety, and autism, as well as prior emotional trauma or abuse should be the first line of treatment for these vulnerable children experiencing discomfort with their biological sex.England, Scotland, Sweden, Denmark, and Finland have all recognized the scientific research demonstrating that the social, hormonal and surgical interventions are not only unhelpful but are harmful. So, these European countries have paused protocols and are instead focusing on evaluating and treating the underlying and preceding mental health concerns.Other medical organizations are adhering to the evidence-based medicine documented in the Cass Review Final Report.The constitution of the National Health Service in England will be updated to state, ''We are defining sex as biological sex.''[15]The European Society of Child and Adolescent Psychiatry issued a document titled ''ESCAP statement on the care for children and adolescents with gender dysphoria: an urgent need for safeguarding clinical, scientific, and ethical standards.''In this paper, they stated, ''The standards of evidence-based medicine must ensure the best and safest possible care for each individual in this highly vulnerable group of children and adolescents. As such, ESCAP calls for healthcare providers not to promote experimental and unnecessarily invasive treatments with unproven psycho-social effects and, therefore, to adhere to the ''primum-nil-nocere'' (first, do no harm) principle''.[16]Health care professionals around the world are also acknowledging the urgent need to protect children from harmful ''gender-affirming'' interventions.In a letter to the British newspaper, The Guardian, sixteen psychologists, some of whom worked at the Tavistock Center for Gender Identity Development Service, acknowledged the role clinical psychologists played in placing children on an ''irreversible medical pathway that in most cases was inappropriate.''[17]In the United States, a group of psychiatrists, physicians and other health care workers wrote an open Letter to the American Psychiatric Association (APA), calling on the APA to explain why it glaringly ignored many scientific developments in gender-related care and to consider its responsibility to promote and protect patients' safety, mental and physical health.[18]Despite all the above evidence that gender affirming treatments are not only unhelpful, but are harmful, and despite the knowledge that the adolescent brain is immature, professional medical organizations in the United States continue to promote these interventions. Further, they state that legislation to protect children from harmful interventions is dangerous since it interferes with necessary medical care for children and adolescents.The American Psychological Association states it is the largest association of psychologists worldwide. The organization released a policy statement in February 2024 stating, ''The APA opposes state bans on gender-affirming care, which are contrary to the principles of evidence-based healthcare, human rights, and social justice.''[19]The Endocrine Society responded to the Cass Review by reaffirming their stance. ''We stand firm in our support of gender-affirming care'.... NHS England's recent report, the Cass Review, does not contain any new research that would contradict the recommendations made in our Clinical Practice Guideline on gender-affirming care.''[20]The American Academy of Pediatrics (AAP) Board of Directors in August 2023, voted to reaffirm their 2018 policy statement on gender-affirming care. They did decide to authorize a systematic review but only because they were concerned ''about restrictions to access to health care with bans on gender-affirming care in more than 20 states.''[21]Of note, Dr. Hilary Cass called out the AAP for ''holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.''[22]In Conclusion
Therefore, given the recent research and the revelations of the harmful approach advocated by WPATH and its followers in the United States, we, the undersigned, call upon the medical professional organizations of the United States, including the American Academy of Pediatrics, the Endocrine Society, the Pediatric Endocrine Society, American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to follow the science and their European professional colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex. Instead, these organizations should recommend comprehensive evaluations and therapies aimed at identifying and addressing underlying psychological co-morbidities and neurodiversity that often predispose to and accompany gender dysphoria. We also encourage the physicians who are members of these professional organizations to contact their leadership and urge them to adhere to the evidence-based research now available.
In the United States of America, on June 6, 2024, this declaration was authored and signed by the American College of Pediatricians and co-signed by:
Medical and Health Policy Organizations
Alliance for Hippocratic Medicine (AHM)
American Academy of Medical Ethics
American Association of Christian Counselors (AACC)
American College of Family Medicine (ACFM)
American College of Pediatricians (ACPeds)
Association of American Physicians and Surgeons (AAPS)
Catholic Health Care Leadership Alliance (CHCLA)
Catholic Medical Association (CMA)
Christian Medical & Dental Associations (CMDA)
Coalition of Jewish Values
Colorado Principled Physicians
Genspect
Honey Lake Clinic
International Foundation for Therapeutic and Counseling Choice (IFTCC)
National Association of Catholic Nurses, USA
National Catholic Bioethics Center (NCBC)
North Carolina Physicians for Freedom (NCPFF)
South Carolina Physicians for Freedom (SCPFF)
Doctors and Health Leaders
Jane E. Anderson, MD, FCPPediatricianVice President, American College of PediatriciansClinical Professor, Pediatrics, University of California, San Francisco (retired)
Michael Artigues, MD, FCPPediatricianPresident, American College of Pediatricians
Jeff Barrows, MD Obstetrician and Gynecologist Senior Vice President of Bioethics and Public Policy, Christian Medical & Dental Associations
Thomas Benton, MD, MPH, FCPPediatricianBoard Member and Healthcare Conscience Council Chair, American College of Pediatricians
Karl Benzio, MDBoard Certified PsychiatristChief Medical Officer, Honey Lake ClinicNew Jersey State Co-Director, American Association of Medical EthicsMedical Director, American Association of Christian CounselorsSexual and Gender Identity Task Force Member, Christian Medical &; Dental AssociationsPhysician Resource Council Member, Focus on the Family
Jonathan Berry, MD Cardiologist Advisory Board, North Carolina Physicians for Freedom
Jessica Bishop-Funk, DDSDentistAdvisory Board, North Carolina Physicians for Freedom
David Bohle, MDCardiologistAdvisory Board, North Carolina Physicians For Freedom
Lisa Brandes, MDPhysician, Family MedicineBoard Member, American College of Family Medicine
Louis Brown, Jr., JDExecutive Director, Christ Medicus FoundationFounding Board Member and Vice President of Public Policy, Catholic Health Care Leadership Alliance
Christina Chan, MD, MABHP, FIDSA, FA, FCP Adult and Pediatric Infectious Disease Specialist and Clinical Researcher American College of Pediatricians
Mike Chupp, MDGeneral SurgeonChief Executive Officer, Christian Medical and Dental Associations
Paul Cieslak, MDPhysician, Infectious DiseaseWest Regional Director, Catholic Medical Association
Michelle Cretella, MD, FCP Pediatrician Adolescent Sexuality Council Co-Chair and Past Executive Director, American College of Pediatricians
Paul Dassow, MD, MSPHPhysician, Family MedicinePresident, American College of Family Medicine
Mario Dickerson, MTSExecutive Director, Catholic Medical Association
Joe Dougherty, MDPhysician, Family MedicineBoard Member, American College of Family Medicine
Fred Fakharzadeh, MDOrthopedic SurgeonChair, Catholic Social Teaching and Justice in Medicine Committee, Catholic Medical Association
John Falcon, M.S., MDPhysician, Emergency MedicineFounding Physician, South Carolina Physicians for Freedom
Scott Field, MD, FCPPediatrician, Pediatric Clinical ResearcherMembership Committee Chair and Past Board Member, American College of Pediatricians
Steven Foley, MDObstetrician and Gynecologist
Salwa Gendi, MD, FCPPediatric Cardiologist, Associate Professor of Pediatric CardiologyBoard Member, American College of Pediatricians
Brooke Gensler, MDPhysician, Family MedicineAt-Large Board Member, Catholic Medical Association
Stanley Goldfarb, MDNephrologist
Russell Gombosi, MD, FCPPediatricianPast Treasurer and Past Board Member, American College of Pediatricians
George Gonzalez, MD Physician, Family Medicine President, Christian Medical and Dental Associations
Diane T. Gowski, MDPhysician, Internal Medicine and Critical Care MedicineSoutheast Regional Director, Catholic Medical Association
Miriam Grossman, MDChild, Adolescent, and Adult PsychiatristAuthor, Lost in Trans Nation
Joe Guarino, MD, MPHPhysician, Occupational MedicineBoard Member, North Carolina Physicians for Freedom
Donna Harrison, MDObstetrician and GynecologistChair, Alliance for Hippocratic Medicine
Nicole Hayes, MPAExecutive Vice President, American Academy of Medical Ethics
Laura Haygood, MD, FAADDermatologist
Laura Haynes, Ph.D.Executive Board, USA Country Representative, Chair-Science and Research Council,International Federation for Therapeutic and Counseling Choice
Jim Heid, MDPhysician, Family MedicineBoard Member, American College of Family Medicine
Roy Heyne, MDPediatrician Co-Chair, Education Committee, Catholic Medical Association
David Hilger, MDDiagnostic RadiologistVice President, Catholic Medical Association
Marie Hilliard, MS, MA, JCL, PhD, RNCo-Chair of the Ethics Committee, Catholic Medical AssociationSenior Fellow, National Catholic Bioethics Center
Jane Hughes, MDOphthalmologistPresident, Association of American Physicians and Surgeons
Patrick Hunter, MD, MSC (Bioethics)Pediatrician
Janet Hurley, MDPhysician, Family MedicineVice President, American College of Family Medicine
Nicole M. Johnson, MD, DNBPASIndependent Consultant, Pediatrics and Pediatric Critical Care Medicine
Patricia Lee June, MD, FCPPediatricianScientific Policy Committee Chair and Past Board Member, American College of Pediatricians
David Kay, MDCardiologistMedical Director, North Carolina Physicians for Freedom
Staci Kay, NPNurse PractitionerBoard Member, North Carolina Physicians for Freedom
Mary Keen-Kerchoff, MD, FCPPediatricianCo-Chair, Education Committee, Catholic Medical Association
Michael K. Laidlaw, MDEndocrinology, Diabetes, and Metabolism
John I. Lane, MDRadiologistVice President, Federation Internationale des Associations de M(C)decins CatholiquesPast President, Catholic Medical Association
Erika L. LeBaron, DO, MSNPhysician, Family MedicinePresident-Elect, Association of American Physicians and Surgeons
Diana LightfootPolicy Director, North Carolina Physicians for Freedom
Joseph Meaney, PhD, KMPresident, National Catholic Bioethics CenterFounding Board Member, Catholic Health Care Leadership Alliance
Carrie Mendoza, MDPhysician, Emergency Medicine Director, Genspect USA
Rabbi Yaakov MenkinManaging Director, Coalition for Jewish Values
Tim Millea, MDOrthopedic SurgeonChair, Health Care Policy Committee, Catholic Medical Association
Travis J. Morell, MD, MPHDermatologistChair, Colorado Principled Physicians
Peter Morrow, MDPhysician, Internal MedicinePast President, Catholic Medical Association
Jennifer Roback Morse, Ph.D.Founder and President, The Ruth Institute
Alfonso Oliva, MD, FACSSurgeon, Plastic Surgery and Reconstructive Plastic SurgeryTreasurer, Catholic Medical Association
Anthony Oliva, MDGeneral SurgeonNortheast Regional Director, Catholic Medical Association
David Olson, MD, FCPPediatricianBoard Member, American College of Pediatricians
Stella O'MallyExecutive Director, Genspect
Jane Orient, MDPhysician, Internal MedicineExecutive Director, Association of American Physicians and Surgeons
Megan Pasookhush, PharDPharmacistBoard Member, North Carolina Physicians for Freedom
L. David Perry, MD, FCPPediatricianBoard Member, American College of Pediatricians
David Pickup, LMFT-SPsychotherapist, Gender/SexualityThe Alliance
Robin Pierucci, MD, FCPNeonatologistBoard Member and Pro-Life Council Co-Chair, American College of Pediatricians
Thomas M. Pitre, MDUrologistPast President, Catholic Medical Association
Matthew R. Porter, MD, FAAFPPhysician, Family MedicineTreasurer, American College of Family Medicine
Samuel ''Bose'' Ravenel, MDPediatricianAdvisory Board, North Carolina Physicians for Freedom
Kathleen Raviele, MDObstetrician and GynecologistPast President, Catholic Medical Association
Steven Roth, MDAnesthesiologistChairman, Coalition for Jewish Values Healthcare Council
Richard W. Sams II, MDPhysician, Family Medicine, MA (Ethics)Board Member, American College of Family Medicine
Richard H. Sandler, MD, FCPPediatric GastroenterologistTreasurer and Pro-Life Council Co-Chair, American College of PediatriciansProfessor of Pediatrics, University of Central Florida
Emily SaundersNetwork Director, North Carolina Physicians for Freedom
Weston Saunders, MDPhysician, Family PracticeMedical Director, North Carolina Physicians for Freedom
Rabbi Yoel SchonfeldPresident, Coalition for Jewish Values
Mike Semelka, DOPhysician, Family MedicineBoard Member, American College of Family Medicine
Bryan C. Shen, MMSACRegistered Counsellor and Supervisor, SACBoard Member, International Foundation for Therapeutic and Counseling Choice
Jill M. Simons, MD, FCPPediatricianExecutive Director, American College of Pediatricians
Michelle Stanford, MD, FCPPediatricianPresident, Catholic Medical Association
Lisa Stewart, CPAChief Executive Officer, Honey Lake Clinic
Kristin Strange, MDPediatricianAdvisory Board, North Carolina Physicians for Freedom
Rev. D. Paul Sullins, Ph.D.Research Professor of Sociology, The Catholic University of AmericaSenior Research Associate, The Ruth Institute
Katy Talento, NDNaturopathic DoctorChief Executive Officer, AllBetterHealth
Angela Thompson, MDObstetrician and Gynecologist
Craig Treptow, MDPhysician, Family MedicineImmediate Past President, Catholic Medical Association
Den Trumbull, MD, FCPPediatricianBoard Member, American College of Pediatricians
Kimberly Vacca, MD, FCPPediatricianSecretary, American College of Pediatricians
Quentin Van Meter, MD, FCPPediatric EndocrinologistAdolescent Sexuality Council Co-Chair and Past President, American College of Pediatricians
Andre Van Mol, MDPhysician, Family MedicineSexual & Gender Identity Task Force Co-Chair, Christian Medical and Dental Associations Christian Medical & Dental Associations and American Academy of Medical Ethics Transgenderism Scholar
Cristl Ruth Vonholdt, MDPediatrician (retired)
Tessa Walters, MDAnesthesiologist
Ron Waterer, MDPhysicianAdvisory Board, North Carolina Physicians for Freedom
Steven White, MDPulmonologistPresident, Catholic Health Care Leadership AlliancePast President, Catholic Medical Association
Joseph Zanga, MD, FCPPediatricianFounding President, American College of Pediatricians
Advocates Protecting Children
Child & Parental Rights Campaign (CPRC)
Desert Stream Ministries
Discovery Institute
Family Research Council
Family Watch International
International Partners for Ethical Care (PEC)
Liberty & Justice for All
Will Pen for Change, LLC
Arina Grossu Agnew, MA, MSFellow, Center on Human Exceptionalism, Discovery InstituteFounder and Principal, Aret(C) Global Consulting
Jennifer Bauwens, PhDDirector of the Center for Family Studies, Family Research Council
Vernadette R. Broyles, Esq.President and General Counsel, Child & Parental Rights Campaign
Eileen Christian, Esq.Vice President, Advocates Protecting Children
Erin Brewer, PhDAdvocates Protecting Children
Andrew Comiskey, MDivFounding Director, Desert Stream Ministries
Theresa FarnanFellow, Person and Identity Project, Ethics and Public Policy Center
Abigail Foard, MA, LPCAssociate Director, Desert Stream Ministries
Mary Rice Hasson, JDDirector, Person and Identity Project, Ethics and Public Policy Center
Martha Shoultz, Esq.Attorney and Board Member, International Partners for Ethical Care
Hannah SmithFounding Director, Liberty & Justice for All
Joshua & Naomi StringerCo-Founders, Will Pen for Change, LLC
Christopher Yuan, DMinSpeaker, Author (Holy Sexuality and the Gospel), Producer (The Holy Sexuality Project, holysexuality.com) Holy Sexuality
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References
[1] Rawee P, Rosmalen JGM, Kalverdiijk L and Burke SM. Development of gender non-contentedness during adolescence and early adulthood. Archives of Sexual Behavior. 2024; https://doi.org/10.1007/s10508-024-02817-5
[2] Diekema DS. Adolescent brain development and medical decision-making. Pediatrics. 2020; 146(s1): e20200818F
[3] deVries ALC, McGuire JK, Steensma TD, et al. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014; 134(4):696-704. https://doi.org/10.1542/peds.2013-2958
deVries ALC, Steensma TD, et al. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011; 8(8):2276-83. DOI: 10.1111/j.1743-6109.2010.01943.x
[4] Abbruzzese E, Levine SB, Mason JW. The myth of 'reliable research' in pediatric gender. medicine: A critical evaluation of the Dutch studies '' and research that has followed. J Sex & Marital Therapy. 2023; 48(6): 673-699.
[5] Cass H. The Cass Review. April 2024. https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf
[6] This article is in German (author is Zepf) and the link is https://econtent.hogrefe.com/doi/10.1024/1422-4917/a000972
The National Library of Medicine has the summary in English
Zepf FD, Konig L, et al. (Beyond NICE: Updated systematic review on the current evidence of using puberty blocking pharmacological agents and cross-sex-hormones in minors with gender dysphoria.) Z Kinder Jugendpsychiatr Psychother. 2024; 52(3):167-187. https://pubmed.ncbi.nlm.nih.gov/38410090/
[7] Hembree, W., Cohen-Kettenis, et al., (2017) Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab,102:1''35.
[8] Zucker, K.J. Debate: Different strokes for different folks. Child Adolesc Ment Health. 2020; 25(1): 36-37. https://doi.org/10.1111/camh.12330
[9] Lupron Depot Prescribing Information. https://www.lupron.com/pi.html
[10] Supplement to Citizen Petition from Nancy Stade et al. Posted by the Food and Drug Administration on April 15, 2024. https://www.regulations.gov/document/FDA-2023-P-3767-0654
[11] Endocrine Society Guidelines at Hembree, W., Cohen-Kettenis, et al., (2017) Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab;102:1''35.
[12] Laidlaw M, Van Meter QL, Hruz PW, Van Mol A and Malone WJ. The Journal of Clinical Endocrinology & Metabolism, 2019;104(3): 686''687. https://doi.org/10.1210/jc.2018-01925
[13] Hughes, M. The WPATH Files. Pseudoscientific surgical and hormonal experiments on children, adolescents, and vulnerable adults. Environmental Progress. March 4, 2024. https://environmentalprogress.org/big-news/wpath-files
[14] American College of Pediatricians. Mental Health in Adolescents with Incongruence of Gender Identity and Biological Sex. Position Statement. Feb 2024. https://acpeds.org/position-statements/mental-health-in-adolescents-with-incongruence-of-gender-identity-and-biological-sex
[15] Zindulka K. Win for Reality: UK's National Health Service constitution to declare 'sex is biological'. Breitbart News. April 30, 2024. https://www.breitbart.com/europe/2024/04/30/win-for-reality-uks-national-health-service-constitution-to-declare-sex-is-biological/
[16] Radobuljac MD, Groselj U, et al. ESCAP statement on the care for children and adolescents with gender dysphoria: an urgent need for safeguarding clinical, scientific, and ethical standards. European Child & Adol Psych. 2024. doi.org/10.1007/s00787-024-02440-8
[17] Letters to the Editor. We are ashamed of the role psychology played in gender care. The Guardian. April 21, 2024. https://www.theguardian.com/theobserver/commentisfree/2024/apr/21/we-are-ashamed-of-role-psychology-played-gender-care-observer-letters
[18] An open letter to the American Psychiatric Association regarding the publication of gender-affirming psychiatric care. Foundation Against Intolerance and Racism. January 2024. https://www.fairforall.org/open-letters/open-letter-apa/?fbclid=IwAR17__BG0RtNqbUVcivxTRkx0AmABT5t7o-8Vg_tYKydzKBBXJ6xgsEYbQ8
[19] APA policy statement on affirming evidence-based inclusive care for transgender, gender diverse, and nonbinary individuals, addressing misinformation and the role of psychological practice and science. American Psychological Association February 2024. https://www.apa.org/about/policy/transgender-nonbinary-inclusive-care.pdf
[20] Endocrine Society statement in support of gender-affirming care. May 8, 2024. https://www.endocrine.org/news-and-advocacy/news-room/2024/statement-in-support-of-gender-affirming-care
[21] Wyckoff AS. AAP reaffirms gender-affirming care policy, authorizes systematic review of evidence to guide update. August 4, 2023. https://publications.aap.org/aapnews/news/25340/AAP-reaffirms-gender-affirming-care-policy?autologincheck=redirected
[22] Ghorayshi A. Hilary Cass says U.S. doctors are 'out of date' on youth gender medicine. The New York Times. May 13, 2024. https://www.nytimes.com/2024/05/13/health/hilary-cass-transgender-youth-puberty-blockers.html