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« Saturday Morning Coffee Break & Prayer Revival | Main | Saturday Gardening, Puttering and Adventure Thread, August 6 »
August 06, 2022

What is happening to the The American Academy of Pediatrics?

pediatr.jpg

Pediatric care, 1960

Back on June 9, Muldoon wrote a great post about the American Academy of Pediatrics, entitled The Moral Abdication of The Academy. I encourage you to re-read it. Here's a short excerpt:

While certainly the AAP and its various sub-committees have been instrumental in many advances in the medical and surgical treatments of major medical problems affecting children, the organization has a less savory side.

When I began my pediatric training in the mid 1980s it was expected as a matter of course that pediatric residents would automatically join the AAP. It was axiomatic that "pediatrician = AAP member". The mantra in those days was that we were to be "advocates for children". The pediatrician was to utilize his expertise to enhance, fortify and augment parents' ability to raise healthy children. The pediatrician and the parents, as a team, endeavored to help children become functioning adults, with well-rounded physical, mental and social capabilities. We were taught to respect the cultural and ethnic background of each family. Somewhere along the way, there began a shift from augmenting and enhancing, to overruling and usurping parents.

The AAP issues numerous policy statements, intended to address particular pediatric health issues authoritatively, from a position of being subject matter experts. These policy statements originally served as 'guidelines' for pediatricians, but have evolved to become the 'standard of care' for general pediatricians in their daily practices. AAP positions are cited as gospel and deviations from them are shunned. Busy pediatricians nearly always defer to the expert position, as the path of least resistance. Also, AAP statements are not just aimed at practicing pediatricians. More and more they are aimed at public policy makers, legislators and government agencies. I have been noticing some unsettling trends and techniques among the AAP's statements. Let's look at a few examples.

The examples Muldoon gives fall into four categories. I am afraid that there are a couple of new, specific illustrations since Muldoon wrote that post. Let's see how well these fit into the categories Muldoon set forth:

EXAMPLE #3: Intentional distortion and misrepresentation of statistics.

The American Academy of Pediatrics sponsors a medical journal, Pediatrics, which published a paper on August 3 which purported to dismiss the key points of Abigail Shrier's book, Irreversible Damage: The Transgender Craze Seducing Our Daughters. The lead author of the paper is Jack Turban. I thought it would be a good idea to watch Shrier's Twitter feed for responses. And they came:


I'm so frustrated major journals like Pediatrics allow activist clinicians to overclaim and distort. It doesn't help trans people in the long run to flood the zone with shoddy science.

2/ To take one of many examples, this paper argues that from 2017 to 2019, the % of adolescents identifying as trans *dropped by a third*. Does anyone, anywhere think this is true? Jack Turban doesn't -- in July of 2021, in a sworn statement, he endorsed the idea of a rise.

This came in before the Pediatrics paper: The Beginning of the End of 'Gender-Affirming Care'? Is this one reason the AAP published a new paper?

Britain is closing the infamous Tavistock Centre. Finland and Sweden have radically revised their treatment guidelines. But American doctors are advertising surgeries to children on TikTok.

A major refutation to the Pediatrics piece came in yesterday . I am no statistician, but I have heard some statisticians defend statistical programs. And the logical and statistical arguments used in this paper just don't meet minimum standards. Leor Sapir writes in City Journal:

A new study in the journal Pediatrics sets out to refute a central claim made by critics of pediatric gender transition: that social pressure rather than organic processes is the major cause of transgender self-identification among youth. Among the study's authors is Jack Turban, an oft-quoted proponent of "gender affirming care" (GAC) and propagator of the affirm-or-suicide myth.

Pediatrics, recall, is the journal that published Jason Rafferty's thoroughly debunked 2018 article purporting to find conclusive evidence that alternatives to GAC are futile and harmful. That article has become Exhibit A in efforts by policymakers to promote GAC and is widely cited by activist groups working with schools to make (iatrogenic) "social transition" easier for students. The American Academy of Pediatrics (AAP), which publishes Pediatrics, has spent the past few years suppressing petitions from members to conduct a thorough review of the evidence on this issue. According to the Society for Evidence-Based Gender Medicine, Michael Biggs, a U.K. researcher who has published on this topic, submitted a rebuttal to the AAP, which the organization refused to publish (offering no explanation). It is becoming increasingly clear that AAP's policy on this issue is "no debate."

This is very disturbing. "No debate" makes this professional organization sound like a grievance studies department in a university.

Turban takes aim at the two key claims driving the social-genesis approach. The first, known as the social contagion hypothesis, is that adolescents adopt a transgender identity in response to social cues and pressures. This phenomenon was first documented in a 2018 study by Lisa Littman and inspired Abigail Shrier's book Irreversible Damage. Its plausibility has since been strengthened by clinicians working in the field. According to some proponents of the contagion hypothesis, the effect exists mostly or even exclusively among teenage girls. Relying on a supplemental questionnaire adopted by 16 states on the CDC's biennial Youth Risk Behavior Survey, however, Turban finds that more boys than girls identified as trans in 2017 (1.5 boys for every girl) and 2019 (1.2 boys for every girl). Thus, he concludes, the contagion hypothesis is false.

This is an astonishing leap of logic. First, the supplemental questionnaire asks respondents whether they self-identify as transgender. It gives them four options: yes, no, I don't know, and I don't understand the question. Turban includes only those who said yes (2.4 percent in 2017, 1.6 percent in 2019). He leaves out those who answered, "I don't know," a far more numerous category (4 percent). . .

Second, the supplemental questionnaire also asks respondents what their "sex" is. Turban assumes that respondents understand this second question to mean "sex assigned at birth" rather than "gender identity," and cites three studies to confirm that that is how teenagers "are likely to understand" the word "sex." Yet the first two citations say nothing of the sort, and the third only weakly hints in that direction. No less damning, the researcher who developed the questionnaire for the CDC has herself emphasized the "uncertainty as to whether transgender students responded to the sex question with their sex or gender identity."
Third, Turban's claim about the sex ratio is inconsistent with existing data, which clearly show a strong predominance of girls over boys. These trends have been documented in peer-reviewed research, are internationally observed, and have remained fairly steady over the past decade or so. By contrast, Turban's data are solely from the U.S., sample only one-third of states (Turban mentions 16 states, but it appears that the actual number of states collecting data is even lower), and focus only on two specific years. . .

There is much more at the link. Do you think this AAP-sponsored paper fits Muldoon's characterization of "Intentional distortion and misrepresentation of statistics"?

EXAMPLE #4: Expanding the definition of childhood while also granting autonomy to immature individuals

This is part of what Muldoon wrote:

At its inception, the field of Pediatrics self-described as the medical care of children. As time passed, further subcategories of childhood emerged. Advances in newborn care and prevention of common infectious diseases led to a re-categorization into Newborns, Infants and Children. In the 1980s, further expansion defined the transitional phase from child to adult as a unique category, and Adolescent Medicine was born. Now, more recent articles from the AAP speak of Newborns, Infants, Children, Adolescents and Young Adults. Mission creep aside, this has two results. One, it expands the definition of childhood even further, and two, it blurs the line between childhood and adulthood.This creates the ironic situation where childhood is extended well into the 20's, while simultaneously granting pre-teens the autonomy to make life-changing decisions about sexuality and sexual development, such as puberty blockers, male or female hormone enhancement, or surgical genital mutilation.

For decades, Adolescent Medicine specialists have planted and nourished a notion of autonomy and confidentiality between the adolescent and the physician. There comes a point however, when claiming to affirm a pre-teen or teen's feelings or self-image (no matter how delusional it may be) comes into conflict with the parents' lifelong commitment, rights, and responsibilities as the guide for that youth's development from child to adult. At some point, a physician as counselor encouraging a youth to reject the culture, traditions and mores of his/her parents drives a wedge between child and family.

This is happening NOW:

July 18, An Open Letter to the American Academy of Pediatrics:

We write to you from Genspect, an international and non-partisan organization which represents thousands of parents of gender dysphoric children, adolescents, and young adults, as well as trans people, detransitioners, clinicians, and allied groups. We want our children to be affirmed as whole human beings, and we want them to be treated with evidence-based interventions which ensure that benefits outweigh risks. We are very concerned that the AAP is currently representing only one set of views on how best to help our children thrive--namely both social (names, pronouns, etc.) and medical transition (puberty blockers, cross-sex hormones, surgeries), which the AAP refers to as "affirmative care." Many of our children have received this care and are anything but thriving.

This has propelled us to closely read the studies that support these treatments, and we have found that what is claimed about the studies is not at all what the results actually show. . .

. . . We now have several independent systematic reviews of evidence that show that the benefits of these treatments are far from certain. However, the evidence of risks --such as harms to bones and the cardiovascular system, effects on the brain and other organs, sexual difficulties, and a future inability to have kids--are mounting, as evidenced by a growing number of studies. Several countries have now acted on this new information, including Sweden, where "it has been decided that hormonal treatments (i.e., puberty blocking and cross-sex hormones) will not be initiated in gender dysphoric patients under the age of 16. For patients between ages 16 and 18, it has been decided that treatment may only occur within the clinical trial settings approved by the EPM (Ethical Review Agency/Swedish Institutional Review Board). The patient must receive comprehensive information about potential risks of the treatment, and a careful assessment of the patient's maturity level must be conducted to determine if the patient is capable of evaluating, and consenting to, the treatment."

Additionally the UK is undertaking a multi-year review of its gender transition program over concerns that harms outweigh benefits. An official interim report distanced itself from the "affirmation model" by emphasizing that this model of care "originated in the USA" and signaling that change is coming to Great Britain.

So, is the UK scapegoating the USA, or are the activists pushing "gender affirmative care" really worse here?

We have recently become aware that five pediatricians submitted a resolution (#27) to urge the AAP to do a thorough and systematic evaluation of the available evidence and to update the 2018 AAP position paper Ensuring Comprehensive Care and Support for Transgender and Gender Diverse Children and Adolescents, which incorrectly promulgates the notion that "gender affirmative" psychosocial and medical interventions are the only acceptable treatment for gender dysphoric youth. This resolution is timely: thousands of young adults are coming forward on Detrans subreddit and other social media platforms describing their regret. Why is this happening? A recently published peer-reviewed publication warned that the original "Dutch" protocol that is now used to treat dysphoric youth suffers from significant methodological limitations and is not applicable to most of the current cases: namely youth with post-puberty onset of gender dysphoria complicated by mental health or neurocognitive difficulties.

Many Genspect parents have observed such a sudden trans identification in their children, often emerging after an intense and obsessive period of consuming narrowly-focused social media content and watching their friends, one by one, announce a trans identity. Moreover, many of our children suffer from psychological comorbidities . . .

It is long past due for the AAP to address this issue, and we were pleased to see that Resolution 27, introduced by several AAP pediatrician members, finally addressed this. However, we were very disappointed to learn that the AAP leadership chose to specifically disallow pediatrician comments on Resolution 27, omitting it from the list in the link sent to pediatricians soliciting their comments. We understand that this is due to a "new rule" that "unsponsored" resolutions cannot be commented on. It is alarming that not a single chapter or committee within the AAP was willing to "sponsor" a resolution that asks to conduct a non-partisan and systematic review of evidence in pediatric gender medicine - something the AAP has never done. It is even more alarming that the AAP appears to be preemptively suppressing debate by not allowing comments on "unsponsored" resolutions, a rule that did not exist last year when a similar "unsponsored" resolution got many supportive pediatrician votes and comments. . . (emphasis mine)

The entire letter is great. This thread includes a link to an additional detailed rebuttal to the current AAP policy statement on trans-kids (read to the end of the thread for cautions concerning pedophilia); notes on international scandals in the field and ways that pediatricians and others can help change the current situation. Responses to the AAP from pediatricians and others are needed soon.

Does it appear that the AAP is continuing its practice of "Expanding the definition of childhood while also granting autonomy to immature individuals", as Muldoon put it back in June?

Quotes

The creeps that used to pull up to kids in windowless vans offering to help find their dog are now pulling up to schools in Priuses offering to help kids find their gender.

These aren't things normal adults do.

Frank McCormick - Chalkboard Heresy

Response: "It's a growth sector of the economy. Thanks ESG!"

Sex education will ensure that the next generation will not form families, since it will have destroyed in its pupils everything that leads one sex to idealize the other and so to channel erotic feelings into marriage Becoming a Family

Roger Scruton

Apparently, eleven-year-olds need to know how to whore themselves - and to know that whoring is, like, totally valid and empowering - because they may be transgender and may have to pay for hormones and surgical mutilations.

Oh shiny tomorrow.

David Thompson, on education in Loudon County, VA

Music

Mentoring: Jimmy Brown, the Newsboy

* * * * *

Hope you have something real planned for this weekend.

This is the Thread before the Gardening Thread.

Serving your mid-day open thread needs


* * * * *


Here's last week's post, with comments: The Pritzker Billionaires and Synthetic Sex Identities

I closed the comments on this thread so you wouldn't ban yourself by trying to comment on a week-old thread. But don't try it anyway.

digg this
posted by K.T. at 11:08 AM

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