On 16 May 2016, talk show host Glenn Beck published a tweet reporting that a pediatricians’ group had said that promoting or tolerating gender dysphoria (i.e., the condition of feeling one’s emotional and psychological identity as male or female to be opposite of one’s biological sex) in children constitutes “child abuse”:
American College of Pediatricians: Promoting Gender Dysphoria Ideology Is ‘Child Abuse’ https://t.co/5yoPFk2H2u
— Glenn Beck (@glennbeck) May 16, 2016
Beck’s tweet led many viewers to believe that the American Academy of Pediatrics (AAP) had taken that stance on childhood gender dysphoria, but the tweet linked to an article containing quotes from the American College of Pediatricians (ACPeds) not the AAP:
The American College of Pediatricians recently issued a temporary position statement on so-called gender identity disorder, or gender dysphoria. A full statement will be issued this summer. The temporary statement is prefaced with the following:
The American College of Pediatricians urges educators and legislators to reject all policies that condition children to accept as normal a life of chemical and surgical impersonation of the opposite sex. Facts — not ideology — determine reality.
“They say human sexuality is an objective, biological, binary trait, XY and XX are genetic marks of health, not genetic markers of disorders,” Co-host Pat Gray said on The Glenn Beck Program.
“Now that seems to fit in with what, kind of, the politically correct crowd is saying right now, that gender is just a state of mind.”
ACPeds is a very small group formed relatively recently in response to political disagreements over same-sex parenting, not out of any specific focus on pediatrics or the wellness of children (and the organization is classified as a hate group by the Southern Poverty Law Center). By ACPeds’ own admission, their original aim was to promote parenting by heterosexual married couples:
The Mission of the American College of Pediatricians is to enable all children to reach their optimal physical and emotional health and well-being. To this end, we recognize the basic father-mother family unit, within the context of marriage, to be the optimal setting for childhood development, but pledge our support to all children, regardless of their circumstances. The American College of Pediatricians promotes a society where all children, from the moment of their conception, are valued unselfishly. We encourage mothers, fathers and families to advance the needs of their children above their own. We expect societal forces to support the two-parent, father-mother family unit and provide for children role models of ethical character and responsible behavior.
Beck’s material linked to a previous statement issued by ACPeds (“Gender Ideology Harms Children”) that some social media users confused with a study. The statement opened with the portion Beck excerpted before issuing an eight-point initial platform on gender identity in children, which stated (among other things) that human sexuality is an objective biological binary trait, puberty-blocking hormones can be dangerous, and that rates of suicide are twenty times greater among adults who use cross-sex hormones and undergo sex reassignment surgery.
The statement provided citations for its claims, including references to seemingly conflicting information from the respected American Psychiatric Association’s “Gender Dysphoria Fact Sheet”:
In the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people whose gender at birth is contrary to the one they identify with will be diagnosed with gender dysphoria. This diagnosis is a revision of DSM-IV’s criteria for gender identity disorder and is intended to better characterize the experiences of affected children, adolescents, and adults … DSM-5 aims to avoid stigma and ensure clinical care for individuals who see and feel themselves to be a different gender than their assigned gender. It replaces the diagnostic name “gender identity disorder” with “gender dysphoria,” as well as makes other important clarifications in the criteria. It is important to note that gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition.”
The APA’s position is that gender dysphoria is “not in itself a mental disorder,” and that children are a demographic group at risk for compromised clinical care. A part of ACPeds’ citation that bordered on deceptive was the fact that the American Psychiatric Association’s fact sheet discussed changes to diagnostic criteria implemented around 2013, but ACPeds went on to cite studies that were typically more than a decade old and in direct conflict with medical science directives issued several years (and several studies) later.
A September 2015 presentation from the American Academy of Pediatrics notes that treatment recommendations are based on the best available evidence. Their guidance defined three approaches to gender dysphoria in children: “corrective,” “supporting,” and “affirming,” with the AAP advising the “affirming” approach to gender dysphoria in children:
In February 2016, the AAP (not ACPeds) published a number of studies and articles about gender identity and pediatrics, including findings that acceptance of gender identity is associated with low risk of depression and anxiety in dysphoric pediatric patients. One AAP article referenced research indicating that familial support and acceptance correlates strongly with positive mental health outcomes:
The study, “Mental Health of Transgender Children Who are Supported in Their Identities,” in the March 2016 issue of Pediatrics (published online on Feb. 26) presents new research on the positive mental health outcomes of prepubescent transgender children who socially transition, or begin to live expressing their gender identities.
Researchers found that children allowed to exhibit their gender, by changing their names, clothing, pronoun use, and hairstyles, had normal levels of depression, and anxiety levels only slightly above their peers. The study compares a national sample of 73 transgender prepubescent children, ages 3 to 12, with 49 of their siblings and a control group of 73 “typically developing” children of the same ages.
While previous research has shown that gender nonconforming youth often have elevated rates of depression and anxiety, this study suggests that familial support can be associated with good mental health outcomes among transgender children. The study authors suggest that further research will be important to evaluate the mental health of transgender children as they move into adolescence.
The cited study’s conclusion [PDF] again demonstrated evidence in direct conflict with ACPeds’ assertions:
Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group. Especially striking is the comparison with reports of children with GID; socially transitioned transgender children have notably lower rates of internalizing psychopathology than previously reported among children with GID living as their natal sex.
On 20 April 2016, the AAP formally called for the repeal of recent bathroom bills aimed at preventing transgender individuals (including children) from using the facilities which matched their gender identity. A larger March 2016 study published by the AAP assessed best practices in treating dysphoric patients.
ACPeds and the AAP are vastly different groups. The former has an estimated membership of between 60 and 200 pediatricians, while about 64,000 such physicians are aligned with the AAP. ACPeds also explicitly states a mission that is overtly political rather than medical in nature.
The “gender ideology” statement wasn’t ACPeds’ first effort to mislead parents. In January 2016, the group issued a statement riddled with false and dangerous information about the HPV vaccine Gardasil.
Garofalo, Dr. Robert. “Understanding Gender Nonconformity in Childhood and Adolescence.”
Children’s Hospital of Chicago Gender & Sex Development Program. September 2015 (pp. 26-28).
Jenco, Melissa. “AAP Calls For Repeal Of N.C. Transgender Law.”
AAP News. 20 April 2016.
Kranish, Michael. “Beliefs Drive Research Agenda of New Think Tanks.”
Boston Globe. 31 July 2005.
Lopez, Ximena, et al. “Approach to Children and Adolescents with Gender Dysphoria.”
Pediatrics. March 2016.
Olson, Dr. Kristina, et al. “Mental Health of Transgender Children Who Are Supported in Their Identities.”
Pediatrics. March 2016.
Glenn Beck. “American College of Pediatricians: Abusive to Promote Gender Dysphoria Ideology.”
16 May 2016.
American Psychiatric Association. “Fact Sheet: Gender Dysphoria.”
AAP Press Room. “Transgender Preadolescents Have Good Mental Health Outcomes After Transitioning Gender Identities.”
26 February 2016.
American College of Pediatricians. “Gender Ideology Harms Children.”
21 March 2016.