A coalition of twenty states has informed the American Academy of Pediatrics (AAP) that it is under investigation for its “misleading and deceptive” claim endorsing puberty blockers as “reversible” treatments for gender-dysphoric youth.
Idaho Attorney General Raul Labrador leads the coalition. In its demand letter served on the AAP yesterday, Labrador requested the medical group’s cooperation in investigating whether its unscientific claim about the drugs violates state consumer protection laws.
“[W]hen it comes to treating children diagnosed with gender dysphoria,” Labrador wrote, “the AAP has abandoned its commitment to sound medical judgment.”
The Idaho AG is referring to the AAP’s 2018 decision to do away with a longstanding pediatric protocol known as “watchful waiting.” That approach allowed gender-dysphoric children to naturally progress through puberty while treating them with counseling and psychotherapy rather than sex-altering drugs.
In its place, the current AAP policy advises doctors to “affirm” a child’s stated desire to change genders by prescribing puberty-blocking drugs and cross-sex hormones. The letter explains how, in 2023, the AAP “reaffirmed” the 2018 AAP policy statement on gender-affirming care, including a statement that “tells physicians, the public, and parents and their children that puberty blockers used to treat adolescents with gender dysphoria are ‘reversible.'”
“That statement is misleading and deceptive,” the letter says.
“It is beyond medical debate that puberty blockers are not fully reversible but instead come with serious long-term consequences,” the letter goes on, citing the National Health Service of England’s landmark Cass Review. That long-term study showed the science simply isn’t there to support these life-altering medical interventions for gender-dysphoric youth.
The letter points out the Review’s findings that “when puberty blocker use is followed directly by cross-sex hormone use, which is often the case, infertility and sterility is a known consequence, at least for those who began puberty blockers in early puberty.”
The AAP’s claim about puberty blockers is even more suspect, “now that the World Professional Association for Transgender Health [WPATH] and its standards of care—the AAP’s apparent cornerstone source—have been exposed as unreliable and influenced by improper pressures.”
Given all these findings, “the AAP has no basis to assure parents that giving their children puberty blockers can be fully reversed. It just isn’t true,” the coalition concludes.
Most states’ consumer protection laws prohibit making statements to consumers that are false, misleading, or deceptive. The letter says those laws apply to the AAP’s claim about puberty blockers.
And because that claim “raises questions” under the consumer laws forbidding these deceptive practices, the coalition has given the group two weeks to respond to over a dozen questions, including, for starters:
1. Explain the draft and review process for the 2018 AAP policy statement and subsequent reaffirmation, including any efforts to verify claims that puberty blockersare reversible when used to treat adolescents suffering from gender dysphoria.2. Provide substantiation for the AAP’s claims that the 2018 AAP policy statement and subsequent reaffirmation are “evidence driven, nonpartisan and rigorously reviewed” and “reflect the latest evidence in the field.”3. Provide substantiation for the AAP’s claims that puberty blockers are reversible when used to treat adolescents suffering from gender dysphoria.
Meanwhile, as the letter points out, the tide is turning against medical intervention, in countries around the world that are intervening to protect children against these untested treatments—treatments that more often than not are unnecessary because most children diagnosed with gender dysphoria “grow out” of it, studies show.
And for the unfortunate patients who realize only after the fact that they’ve “grown out of it,” so far there has been little recourse against the doctors they allege caused permanent damage to their health. They are increasingly turning to the courts, where “detransitioner” lawsuits are mounting. In fact, the AAP is a defendant in one of the cases we covered here.
The states acknowledge the AAP’s recent claim, in the wake of the Cass Review, that it plans to undertake a “systematic review of the evidence” regarding using puberty blockers, cross-sex hormones, and surgical interventions to treat minors with gender dysphoria.
Curiously, the page to which the letter links for that claim no longer appears on the AAP website as of this writing.
Whatever.
And whatever the status of that review, the states say, the fact is that the AAP continues to mislead and deceive consumers by maintaining its claim that puberty blockers are “reversible.” It’s a claim that doctors and their patients rely on and are harmed by, and it requires “immediate retraction and correction.”
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