It’s been three months since the release of the Cass Review, an independent assessment of gender treatment for youths commissioned by England’s National Health Service.
After the release of Cass’s findings, the British government issued an emergency ban on puberty blockers for people under 18. Medical societies, government officials and legislative panels in Germany, France, Switzerland, Scotland, the Netherlands and Belgium have proposed moving away from a medical approach to gender issues, in some cases directly acknowledging the Cass Review. Scandinavian countries have been moving away from the gender-affirming model for the past few years. Reem Alsalem, the United Nations special rapporteur on violence against women and girls, called the review’s recommendations “seminal” and said that policies on gender treatments have “breached fundamental principles” of children’s human rights, with “devastating consequences.”
But in the United States, federal agencies and professional associations that have staunchly supported the gender-affirming care model greeted the Cass Review with silence or utter disregard.
The World Professional Association for Transgender Health, an advocacy organization based in the United States whose
standards of gender care are closely followed domestically,
said Cass was not qualified to judge because she had not practiced gender medicine herself. (To ensure independence, the National Health Service chose Cass for precisely this reason.)
WPATH also said its own standards are “based on far more systematic reviews” than the Cass report. But four years ago, WPATH apparently
blocked publication of a Johns Hopkins systematic review it had commissioned that also found scant evidence in favor of the gender-affirming approach.
Recently released emails show that
WPATH leaders told researchers that their work should “not negatively affect the provision of transgender health care in the broadest sense.”
In other words, the United States continues to put ideology ahead of science.
The
Biden administration has essentially
ceded the issue to the progressive wing of the Democratic Party, incorporating gender-affirming protocols into Department of Health and Human Services policy. Moreover, recently revealed emails indicate that President Biden’s assistant secretary of health, Dr. Rachel Levine, a pediatrician and transgender woman, successfully pushed WPATH to
remove age requirements from its guidelines for gender medicine before their publication, because — mixing political and public health concerns — she thought supporters of gender treatment bans might cite them to show that the procedures are harmful. (WPATH’s draft guidelines had originally recommended age minimums of 14 for cross-sex hormones, 15 for mastectomies, 16 for breast augmentation or facial surgery and 17 for genital surgeries or hysterectomies.)
Republicans have in turn seized on transgender rights
and medicine as a potent culture war issue. This makes it challenging for progressives, liberals and moderates to take any stand on gender issues that might be in line with a party that has become so associated with extreme positions.
Already the gender-affirmation model is taught in leading medical schools, and
all the major professional medical organizations in the United States have officially embraced it in their guidelines, a fact often cited by advocates as evidence of their validity.
Given how entrenched the gender-affirmating model has become, reversing course won’t be easy. If the medical profession turns away from the notion that transitioning young people is necessary and lifesaving, it could open itself up to malpractice suits.
Despite the personal or professional costs to admitting its errors, it is time for people in the American medical and political establishments to open their minds and listen to those doctors who have fully examined the evidence.
Source: Opinion | Why Is the U.S. Pretending to Know Gender-Affirming Care Works? – The New York Times
