The American Academy of Pediatrics (AAP) released updated guidance on Monday recommending pediatricians support name, appearance, and sex changes for children who identify as transgender. But the recommendations ignore important research about underlying mental health issues, social contagion, and desistance in gender dysphoric children and teens.
The AAP guidance says gender-dysphoric children are best served when providers offer a “gender-affirming care model.” The model is based on four key assumptions, according to the AAP: Transgender identity does not constitute a mental disorder; variations in gender identity are normal aspects of human diversity; gender identity evolves from biology, development, socialization, and culture; and mental health issues in gender-dysphoric children most often come from stigma and negative experiences related to their gender identity, not intrinsically from the child.
The Human Rights Campaign, the country’s largest LGBT activist group, applauded the statement on Wednesday, stating it reinforced the “medical and moral imperative to support transgender and gender diverse youth” as “life-affirming and life-saving.”
But something isn’t working.
The AAP recommendations came just a week after the release of a study in its own peer-reviewed journal Pediatrics that found half of teen females who identify as male attempt suicide. The data was collected from a survey of more than 120,000 students ages 11 to 19 from 2012 to 2015. Teens who said they didn’t identify as either male or female were close behind with a 40 percent suicide attempt rate, followed by biological teen males who identified as female at 30 percent. By comparison, the average suicide attempt rates for female and male adolescents without gender dysphoria are 18 percent and 10 percent, respectively.
LGBT activists argue that increased suicide rates result from a hostile culture that harasses and discriminates against LGBT individuals. This jives with the fourth AAP assumption of gender-affirming care—mental health issues are always the fault of negative experiences. But this position rules out the “possibility that the actual transition from female to male might play a role in aggravating stress and provoking one to suicide,” wrote Michelle Cretella, the executive director of the more socially and morally conservative American College of Pediatricians.
Providers and parents who assume transition and acceptance can cure depression in children who identify as transgender risk ignoring underlying abuse, trauma, and mental health disorders. A controversial cover story in The Atlantic this summer on transgenderism in young people gave accounts of a number of “detransitioners,” people who had identified as transgender and then returned to their biological gender after realizing other issues were at the root of their discomfort, and “desisters,” young people whose parents put the brakes on transition to work on other mental and emotional health issues only to find the gender dysphoria eventually dissipated.
Cretella contended the suicide rate study will be used to “continue to pressure families to affirm their children’s gender identity in lieu of their biological sex, lest they drive their children to commit suicide.”
The Atlantic story reported on this trend, and the reporter found parents often face accusations that they are playing with their children’s lives if they question the pace of transition or the existence of gender dysphoria in their children: “Would you rather have a live daughter or a dead son?”
Now the AAP is adding to the pressure by recommending a “path to gender-affirming interventions,” moving from changing one’s hairstyle and clothing to changing one’s legal name and gender and finally leading to sex-change surgery.
This despite recent—and quickly suppressed—research that found rapid-onset transgenderism in teens could be the result of social peer pressure, not an innate identity. If so, the AAP guidance risks the lives of the population it says it exists to protect.
The underlying reality of this issue should be especially concerning to Christians, said Albert Mohler, president of the Southern Baptist Theological Seminary and a WORLD News Group board member.
“Why? Because we're dealing with human beings made in the image of God,” Mohler said on his podcast The Briefing. “This kind of dysphoria, this kind of misunderstanding, this kind of personal trauma and crisis of identity is something to which the Scripture directly speaks. And it speaks so helpfully, even in the first chapters of the Bible, telling us that we do not have to figure out who we are, but rather the Creator, who made us, loves us enough not merely to have made us, but then to tell us who we are.”