Politicizing Pediatrics: How the AAP’s Transgender Guidelines Undermine Trust in Medical Authority

Mar 14, 2019 by

by Leonard Sax, Public Discourse:

The five-year-old boy who transitions to identify as a girl has taken a major step on a road that may lead to treatment with cross-sex hormones, castration, and infertility. Most five-year-old boys who say they are girls will not persist: fifteen years later, in the great majority of cases, that boy will say he is a man, not a woman. But the American Academy of Pediatrics is now on record prioritizing the opinion of a five-year-old over the considered judgment of the child’s parents.

What should you do if your five-year-old son tells you that he is a girl?

The proportion of children and young adults who say that they are transgender is rising at an extraordinary rate, not only in the United States but in other countries as well. In 2009–2010, only forty girls in the United Kingdom requested reassignment to the male gender. In 2017–2018, that number was 1,806 girls, a rise of more than 4,000 percent in less than a decade. The UK Government Equalities Office (yes, it’s a thing) has announced that it will investigate.

What’s going on?

Our nation’s largest association of pediatricians, the American Academy of Pediatrics (AAP), recently released new guidelines for the evaluation and management of children and adolescents who identify as transgender. Previous guidelines have recognized that best practice depends on the age of the child. The great majority of five-year-old boys who say that they are girls will not persist in that conviction; ten years later, most of those boys will say that they are boys. They may be gay, they may be straight, but they are now sure that they are boys. They no longer want to be girls.

Five-year-olds are not mature adults. They are young children. As they grow up, they change in profound ways, particularly after the onset of puberty.

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