Attorney generals from 20 states and legislators from Arizona signed an interrogatory letter to the president of the American Academy of Pediatrics (AAP) about the group’s support of puberty blockers, cross-sex hormones, and surgery for children and adolescents who have been diagnosed with gender dysphoria.

“Often the AAP has exercised its influence responsibly,” states the letter. “… But when it comes to treating children diagnosed with gender dysphoria, the AAP has abandoned its commitment to sound medical judgment.”

The AG letter demanded responses to multiple questions about its child gender policies by October 8, and it stated AAP’s conduct is being reviewed further.

Idaho Attorney General Raul R. Labrador sent the letter, and AGs from Alabama, Arkansas, Florida, Georgia, Iowa, Kansas, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, South Carolina, South Dakota, Texas, Utah, Virginia, and West Virginia signed it, as did the president of the Arizona State Senate and the speaker of the Arizona House.

Sounding an Alarm

The American College of Pediatricians (ACPeds), an alternative medical professional organization, has spent years sounding the alarm on AAP-approved transgender treatments.

ACPeds organized a coalition of health care professionals to create the Doctors Protecting Children Declaration, a document urging organizations to stop promoting what ACPeds calls unethical, harmful practices in treating children with gender dysphoria. Some 82,500 professionals and concerned citizens have signed the declaration.

“We have personally reached out to the AAP leadership and leaders of the other named organizations, asking them to put a stop to this, and have not received a response,” said ACPeds Executive Director Jill Simons, M.D.

“Unfortunately, the leadership of the AAP and other organizations have silenced their very members from engaging in medical discourse when they have put in question these harmful protocols, and they continue to double down on them even as they stand without evidence-based research to support their current positions,” said Simons.

Questioning What’s ‘Reversible’

In encouraging the use of puberty blockers, cross-sex hormones, and surgical interventions, the AAP claims the treatments are reversible. The AG letter says that is “misleading and deceptive.”

“It is beyond medical debate that puberty blockers are not fully reversible, but instead come with serious long-term consequences,” the letter states.

The letter cites the widely recognized Cass Review commissioned by Britain’s National Health Service and published in April.

“The Cass Review was monumental in demonstrating, through the most thorough review of the research and current protocols and outcomes in England, that the current protocols of social affirmation, puberty blockers, and cross-sex hormones do not improve the health outcomes of children with gender dysphoria and in fact there is evidence of causing harm,” said Simons.

“Dr. Hilary Cass’s recommendation has shut down the practice of transitioning kids in England,” said Simons. “Many other European countries are also reversing course and returning to proven medical care, which is supportive mental health and addressing underlying diagnoses.”

Leaked files from the World Professional Association of Transgender Health (WPATH) and a recent statement from the American Society of Plastics Surgeons have bolstered the case against surgical and hormonal trans treatments, says Simons.

APA, AMA Uninterested

A growing number of people are recognizing the validity of the studies, says Dr. Tim Millea, chair of the Health Care Policy Committee and Conscience Rights Protection Task Force of the Catholic Medical Association (CMA).

“Physician organizations such as AAP and [American Medical Association] appear to be uninterested in those studies, at the expense of ongoing harm to Americans that they encourage to enter the ‘gender-industrial’ medical system,” said Millea. “It seems to be true that the leadership of these groups prioritize ideology over science, which is a dereliction of duty in the vocation of medicine.”

Doctors Afraid to Speak Out

Most U.S. pediatricians are members of the AAP. Dissent within the organization has led to the development of alternative professional organizations such as ACPeds. The AAP is too radical for most pediatricians, though they are reluctant to say so, says Simons.

“I speak to countless pediatricians who are members of the AAP who disagree with the AAP’s policies and fully support our efforts to put a stop to these unethical protocols, but they are truly fearful of losing their jobs and the harms that will come to them if they speak out,” said Simons. “I unfortunately speak to pediatricians who have been reprimanded and even fired for speaking out.”

Going to Court

The AAP has been named in multiple lawsuits against doctors and hospitals. Members of ACPeds have served as expert witnesses and submitted amicus briefs to fight the AAP’s gender treatment protocols.

ACPeds also filed a lawsuit against the Biden-Harris administration for its rule requiring doctors to perform gender transition procedures on minors against their medical judgment.

“The American College of Pediatricians is filing this lawsuit against HHS because doctors should never be forced to violate their sound medical judgment and perform life-altering and sterilizing interventions on their patients,” stated ACPeds news release. “Our doctors take an oath to do no harm, but the Biden administration’s rule forces them to violate this oath and perform procedures that are harmful and dangerous to our patients– vulnerable children. What the Biden Administration is calling for is wrong and unlawful.”

Over the past several years, the CMA has been involved in gender intervention cases around the country and plans to file an amicus brief for the Supreme Court case United States v. Skrmetti, scheduled to be heard during the current session.

Changing the Culture

CMA hosted a two-hour panel discussion on September 8, 2024, in which several de-transitioners recounted the harms they suffered from gender transition procedures as minors. The organization wants to make sex-change procedures among children, teens, and young adults unthinkable, says Millea.

“There are three areas of emphasis to accomplish that goal, and two of them are judicial and legislative,” said Millea. “The third is of greatest importance, and that is cultural. The public needs to learn and understand the negative and lifelong risks and complications of gender transition.

“We remain hopeful that doctors will push back against these protocols and follow their oath to do no harm,” said Simons. “There will be a tipping point when doctors are no longer fearful and will speak out.”