Pediatricians testifying in opposition to state bills targeting the treatment of transgender minors are upset that politicians are disregarding the science, and proceeding with bills criminalizing doctors and their patients.
Those politicians have come to understand that in order to make their bills in the slightest bit defensible they can’t explicitly discriminate against transgender people. So in response, the legislation they present has a wide brush stroke affecting all children equally.
Pediatric advocates across the U.S are battling state legislation that discriminates against gender-diverse and transgender youths, including in several states where AAP chapters worked to defeat similar bills last year.
The bills intend to prevent transgender youths from participating on athletic teams or in sports according to their gender identity or prohibit gender-affirming medical care. Bills in several states would penalize pediatricians and other physicians for providing gender-affirming medical care — the care model recommended in the AAP policy Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents.
AAP chapters have argued that the bills discriminate against transgender youths. Pediatricians testifying against the legislation said it is based on myths and misinformation about transgender children and adolescents and a misunderstanding about medical and surgical aspects of gender-affirmative care. They are presenting science, explaining policies of national and international medical and athletic organizations and describing harms the bills would cause.
“As experts, pediatricians are uniquely positioned to advocate for and support these young people. Politics has no place here. These are individual conversations between clinicians, patients and families about what’s best. The AAP applauds the hard work of our chapters focused on protecting transgender youth at the state level,” said AAP CEO/Executive Vice President Mark Del Monte, J.D.
Alaa Al Nofal, M.D., FAAP, a pediatric endocrinologist and South Dakota Chapter co-vice president, said there are many misunderstandings about transgender individuals.
Last year, Dr. Al Nofal accompanied a group of pediatricians and pediatric residents from the South Dakota Chapter to advocate against and help defeat a bill that would have criminalized care for transgender and gender-diverse patients. This year, a new bill was introduced that focuses on transgender youth athletes. In a letter to a state Senate committee, the chapter wrote that the bill is “discriminatory” and “will make a dire situation worse.”
Studies indicate that transgender youths are at an increased risk of mental health problems and suicidal ideation when constantly presented with discrimination. According to a survey from the Centers for Disease Control and Prevention, about 1.8% of high school students identify as transgender; 35% reported that they had attempted suicide. A Pediatrics study found that when individuals who receive medication to align their body with their gender identity, the risk of suicide decreases by about 70%.
“People are worried about males participating in females’ sport, which is not fair for the girls,” Dr. Al Nofal said. “This is not the case here.”
According to the letter from the South Dakota Chapter, “many experts would argue that the early blocking of puberty and the transitioning hormonal treatment minimize the biological effect of genetic sex.”
Some states with pending legislation have had no cases involving transgender athletes wanting to compete or being perceived as having a competitive advantage, according to Rebecca L. Carl, M.D., M.S., FAAP, a member of the AAP Council on Sports Medicine and Fitness (COSMF) Executive Committee.
“It is very political and it’s almost more theoretical,” she said, adding that the legislation exacerbates social and physiological barriers to physical activity for transgender youths and does not promote an inclusive approach for all children.
Dr. Al Nofal agreed. “I’m not saying the stories don’t exist. I’m not aware of any in the state of South Dakota.”
“Pediatricians say state bills would harm transgender youths” can be read in full HERE.