SAN DIEGO—A crowd of more than 50 people protested outside the annual conference of the Pediatric Endocrine Society this weekend over the organization’s “gender-affirming” policies and use of puberty blockers and cross-sex hormones on children.
The demonstrators marched peacefully on the sidewalks bordering the Sheraton Hotel & Marina in San Diego, carrying signs and shouting “biology not ideology,” “puberty blockers don’t stop suicide” and “kids cannot consent to puberty blockers,” among other chants.
Erin Friday, the western U.S. regional co-leader of Our Duty, told supporters gathered in a park near the hotel that the organization represents thousands of parents.
“We are all non-affirming parents,” she said. “We believe in reality and boundaries. None of our children committed suicide—not a one. I can’t say the same for the children who have started puberty blockers and cross sex hormones.”
Our Duty and other allied groups seek to ban the “experimental” and “off-label use” of cross-sex hormones and puberty blockers on children because they present several health risks and lead patients down a path to cross-sex hormones that cause sterilization.
Detransitioners’ Stories
Running counter to the trans activist narrative are several horrific accounts of irreversible damage from those known as “detransitioners” who deeply regret proceeding with varying stages of gender transition. Among them are Cat Cattinson, Chloe Cole, Layla Jane, Abel Garcia, Laura Becker, Daisy Strongin, and David Bacon.Cattinson damaged her singing voice due to testosterone but still hit some high notes in her song, Stardust, and a few others she performed at the rally. She recounted her gender transition experience and regret, but said she was grateful she changed her mind before undergoing surgery.
Two other detransitioners—Camille Kiefel and Madison Judd—weren’t as fortunate. Both women shared at the event how they were “affirmed” by their doctors and therapists to believe they were transgender and had their healthy breasts surgically removed.
“I’m a woman—been one the whole time—no matter what I told myself or anyone else,” said Judd. “I hated my body, and doctors didn’t ask me why or [say] maybe your reasoning might be a little off, [or] maybe you’re not seeing yourself for how beautiful you might be.”
She regrets listening to friends and activists and not her parents.
“My parents were right the whole time,” she said. “All they wanted me to do was slow down. They wanted me to pump the brakes.”
Judd spent thousands of dollars on her transition—funds from family, friends, and strangers—people “who wanted to be kind, and do what they thought was right,” she said. “And, I don’t blame them for that, because if I do that, I can’t forgive myself either. … We’ve all got things to regret but this one feels bigger than me.”
In the age of the Internet, “when you don’t know what to believe,” she said, it’s easy for people to lose one’s sense of reality, especially children.
Kiefel said she sued a social worker and therapist in Oregon for allegedly overlooking her mental health problems and fast-tracking her towards a “non-binary” double-mastectomy in Oregon.
“Gender-affirming care is a shocking abuse of trust by a medical system captive to ideology, not biology,” she said. “The treatments are experimental, risky, and inconsistent. Not only did my providers affirm an identity that did not exist, they removed healthy body parts as a solution.”
Several speakers blamed Big Pharma and the health industry for raking in billions in profits at the expense of gender-confused children who become life-long patients.
Multi-Billion Dollar Industry
The so-called sex reassignment surgery market reached $2.1 billion last year in the U.S. and is expected to more than double to $5 billion by 2030 according to a 2022 report by business consulting firm Grand View Research.
‘Affirmative Care’ Model
The United States is the “most permissive country” for medical gender transitions of children according to a report released in Jan. 16 by Do No Harm, a group that opposes the “radical, diverse, and discriminatory ideology” in the health care industry. The report compares the U.S. with 11 European countries on metrics related to gender transitions.The independent systematic evidence-based review cited safety issues over the long-term effects of puberty blockers and cross-sex hormones. The report, released in February 2022, prompted Britain’s National Health Service (NHS) to announce last July that it would close the now infamous clinic this spring.
SEGM states that long-term studies of adult gender transitioners have “repeatedly failed to show lasting psychological improvements” and further indicate “the possibility of treatment-associated harms.”
“Doctors may be incorrect in their assumptions about the causes, persistence, and future trajectory of adolescent gender dysphoria. The rapidly rising numbers of gender dysphoric youth treated with hormones and surgeries and the delayed onset of regret mean that the scale of possible ... harm will not be known for several years,” according to the review.
Additionally, the review authors recommended that when faced with questions about the causalities of gender dysphoria “clinicians are ethically bound to honestly represent the uncertainty of the current state of knowledge, rather than asserting that body modification is the best, safest, and most effective treatment. When a concerned family seeks our counsel, they are seeking our knowledge, not our political ideation and beliefs.”
PES Positions
In 2018, the Pediatric Endocrine Society (PES) declared its opposition to the Trump administration’s push for the establishment of the “Conscience and Religious Freedom Division” within the U.S. Department of Health and Human Services.The division was intended to protect health care providers who refuse to perform, accommodate, or assist with certain health care services on religious or moral grounds, but PES accused the Trump administration of discriminating against patients based on their reproductive history and gender identity.
“As medical providers for youth in the LGBTQ community and those born with a difference of sex development, we have seen the discrimination and safety concerns that these populations face in the medical setting. Refusal to provide medical treatment for these youth may lead to physical or mental illness that may have been preventable, and could augment their already high risk of suicide,” PES stated.
PES argued the establishment of the Conscience and Religious Freedom Division “would serve to legitimize discrimination.” The organization claimed that it could potentially deny “vulnerable” youth access to healthcare as well as violate human rights and the “ethical principles of beneficence and justice.”
“Our job is first to do no harm, and based on available scientific evidence to date, we continue to support the guidelines for care of transgender and gender diverse youth as laid out by the Endocrine Society and the PES,” she wrote.
Dissenting Views
Dr. Michael Laidlaw, an endocrinologist who treats adults, told The Epoch Times he doesn’t support the gender-affirming model nor using puberty blockers and opposite-sex hormones on children, but is skeptical that the debate over such controversial practices could ever be settled in the U.S. in a Cass Review fashion. Ultimately, he said, the issue will probably be decided in the courts.“I don’t believe that an objective review is possible at the federal level. Too many agencies have been captured by radical trans ideology,” he said. “It’s likely that this will be decided by pending federal lawsuits against the states which are outlawing this treatment for minors.”
Laidlaw belongs to the Endocrine Society whose members include both adult and pediatric endocrinologists, but he isn’t a member of PES which is exclusive to pediatric endocrinologists. He did not attend the conference nor protest.
Claims by PES that the effects of puberty blockers are reversible are unfounded and untrue, and even if they were true it wouldn’t matter, because almost all children who take puberty blockers end up on cross-sex hormones which are not reversible anyway, Laidlaw said.
“Once you use the puberty blockers to stop pubertal development, you’re also going to cause an infertility problem,” he said. “And then, once you add the opposite sex hormones, you’re going to continue infertility and potentially sterilize the person.”
Doctors began using Lupron to treat girls with a rare condition called precocious puberty, or early puberty, which can cause breast development and even menstruation in girls as young as four years old.
The U.S. Food and Drug Administration (FDA) approved Lupron to treat this condition, which was halted before the onset of female puberty at age 11 or 12, but the drug has never been approved to treat gender dysphoria in children.
“It’s not FDA approved. It’s off-label. It’s really experimental, and that’s where the problems come in,” Laidlaw said. “It’s never been studied. There are no randomized controlled studies. It’s never been proven to eliminate gender dysphoria. It’s really a way to stop puberty so that they can eventually start cross-sex hormones.”
Laidlaw is also concerned about a lack of medical studies to determine how puberty blockers affect developing brains during puberty.
“It’s pretty much unknown,” he said.
Because pubertal years are a critical time for bone development, when pediatric endocrinologists use drugs to inhibit the pituitary gland and drastically lower the production of natural sex hormones—testosterone in boys and estrogen in girls—there is a risk they won’t develop healthy bone density, thus putting them at risk of osteoporosis and bone fractures later in life, Laidlaw said.
Girls taking high doses of testosterone, which can range from “six to 100 times above normal levels,” can also become aggressive, and sometimes behave recklessly, which can also have lasting consequences on their lives, he pointed out.
“It’s a real concern,” he said. “As I see it, it’s equivalent to using anabolic steroids.”
People who take high doses of steroids are known to develop hyperactivity, irritability, anger issues, depression, anxiety, and a small percentage can develop psychosis, Laidlaw said.
Dr. Andre Van Mol, a board-certified family physician who co-chairs both the Council on Adolescent Sexuality at the American College of Pediatricians and the Sexual and Gender Identity Task Force at the Christian Medical & Dental Association, agrees.
“That’s one of the possible side effects of testosterone. That’s even true in in men who have male hypogonadism, and you put them on testosterone. That’s one of the things you warn them about: If your family, your workmates, your friends say you’re getting aggressive, you better believe it,” he said.
Aside from mood swings, girls who take testosterone face increased risk of heart attack, stroke, breast and uterine cancer, high blood pressure, severe acne, and other problems, he said.
Van Mol didn’t attend the protest but told The Epoch Times he also objects to the use of puberty blockers and cross-sex hormones on children.
Decades of medical research, some that predates the recent surge in gender dysphoria among youth, shows that the condition resolves by adulthood 85 percent of the time, Van Mol said.
More recent evidence indicates an “overwhelming probability” that the cause of gender dysphoria stems from underlying mental health problems from “adverse childhood experiences by which we mean trauma, less than great family dynamics, and a great overrepresentation of autism spectrum disorder,” he said.
“It’s the problems that came before the gender dysphoria, not the gender dysphoria and stigma leading to the mental health problems,” he said. “They are misdiagnosing the problem. This is a mental health issue, not the biologic impossibility of being born in the wrong body.”
Medical disclaimers in the packaging of Lupron —one of the leading puberty blocking agents used in the U.S. and other generic brands say patients should be warned about potential side effects of depression and suicidal thoughts, he stressed.
“It doesn’t sound like the kind of thing you put a problem child on to improve the mental health,” Van Mol said.
For as long as puberty blockers have been around, those who claim they’re effects are reversible should be able to prove their case, he said, but so far haven’t.
“That’s when this is going to turn around—when this quits being a cash cow for the medical industrial complex, when they see that permanently medicalizing kids to no good end is something that’s going to cost them,” he said.
‘Deceptive’ and ‘Dangerous’
After PES released a position statement (pdf) in October 2019 claiming the effects of puberty blockers are reversible, Laidlaw condemned the practice in an article published in January 2020 in Public Discourse, the Journal of the Witherspoon Institute.“The Pediatric Endocrine Society’s Statement on Puberty Blockers Isn’t Just Deceptive. It’s Dangerous,” he wrote in the title.
Laidlaw suggested it was unethical to continue such medical interventions on children and questioned how PES could make such claims without FDA approval, scientific evidence, and rigorous long-term studies.
Hormone levels don’t normalize for a year or more after children stop taking puberty blockers, and “the overwhelming majority of adolescents on puberty blockers decide not to reverse course, but instead move on to cross-sex hormones,” and some pursue “sterilizing genital surgeries,” he said.
PES stated puberty suppression “is a reversible treatment that decreases the distress of having the ‘wrong’ puberty,” and that treatment alone does not cause infertility, but that hormone therapy in later adolescence “has permanent effects and may affect future fertility.”
The national organization consisting of more than 1,600 members claimed that minors are mature enough to consent to gender transition treatments and chastised dissenting members for public discourse on the issue.
“The adolescent, with maturity to understand the consequences of this treatment, can initiate hormone therapy that induces the physical changes of puberty that are consistent with their gender identity,” PES stated. “As pediatricians and pediatric endocrinologists, we strongly oppose public discourse that misrepresents and contradicts evidence-based standard of care recommendations and risks the well-being of transgender youth and their families.”
In 2017, PES adopted guidelines similar to those of Endocrine Society, which was heavily influenced by the World Professional Association for Transgender Health (WPATH), a transgender advocacy group with its own set of guidelines, to which several authors of the Endocrine Society guidelines belong as members, Laidlaw said.
“So, the way I look at is basically WPATH wrote the Endocrine Society guidelines,” he said.
Just because WPATH calls its guidelines “standards of care,” doesn’t make them so, according to Van Mol.
“All of these pro-transitioning so-called standards come from WPATH which is not a scientific organization—not medical—not legal,” Van Mol said, stressing that WPATH removed all age recommendations for cross-sex hormones and gender transition surgeries in the eighth version of its guidelines released last September.
Laidlaw, who testified before British Parliament’s House of Lords, said leading British psychologists have called for a new model of care that would involve taking a deeper look at a patient’s life and events that may have led them to the point of seeking medical interventions and sex reassignment surgery.
“When you listen to these detransitioners, they’ve had trouble in their lives. They’ve had mental health issues,” Laidlaw said.
