Endocrine Society Urged to Reconsider Aggressive Treatments for Children

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It’s not too late to reconsider. That’s the message the Endocrine Society, one of North America’s most influential medical bodies, should take to heart as its annual meeting is held in Boston this week.

This society is a prominent proponent of aggressive, invasive, and irreversible “gender-affirming” treatments for children. Over the years, it has significantly influenced lawsuits that nullify state laws aimed at protecting children. Judges, politicians, physicians, and patients often seek its guidance. Nevertheless, recent developments should prompt the Endocrine Society to rethink its position for the well-being of children.

As a seasoned endocrinologist who attended the society’s 2023 meeting in Chicago, I can attest that my peers and I have long recognized the flimsy evidence supporting “gender-affirming” treatments for children.

The society itself acknowledged this in 2017, when it fully endorsed such treatments based on what it described as “low” and “very low” quality evidence admitted. It also explicitly stated that it places a high value on children’s physical appearance while showing less concern for potential medical harm to these vulnerable young people explicitly stated. Consequently, endocrinologists in the U.S. and Canada widely administer puberty blockers and cross-sex hormones to children, opening the door to eventual sex-change surgeries.

However, since last year’s meeting, the Endocrine Society has faced mounting, and justified, scrutiny. Notably, the United Kingdom’s Cass report, authored by esteemed pediatrician Dr. Hilary Cass, criticized the Endocrine Society’s guidelines for their “lack[ing] developmental rigour.” She concluded that there’s “no good evidence on the long-term outcomes” of the highly aggressive (and largely experimental) treatments the society promotes.

So, what does the evidence indicate? Cass concluded that, generally, “a medical pathway will not be the best way to manage [children’s] gender-related distress.”

The data support this: At least 80% of children who believe they are transgender, and potentially up to 94%, eventually determine they are not. These children don’t require body- and mind-altering chemicals and surgeries that change them into something they are not.

What they need is caution, counseling, and, most importantly, time to understand who they are. In other words, they need exactly what the Endocrine Society does not support.

The question now is whether the Endocrine Society will shift its perspective and prioritize children’s health. The initial signs are not promising. It responded to the Cass report by appealing to emotion rather than evidence: “We stand firm in our support of gender-affirming care” on the grounds that it’s “needed and often lifesaving.”

Such statements demonstrate little regard for the medical science and ethics that true care requires. As Cass has noted following her report, groups like the Endocrine Society are “misleading the public.”

The society has initiated its own review of the evidence, yet this also seems unpromising. The panel overseeing the review is stacked with physicians who have conflicts of interest, including several connected to an outright advocacy group, the World Professional Association for Transgender Health (WPATH).

WPATH has a history of using the Endocrine Society as its spokesperson, lending its extreme treatment demands a semblance of medical authority. WPATH also conducted its own evidence review, only to obscure it when researchers found a lack of support. Given WPATH’s influence, the Endocrine Society seems likely to reach a pre-determined conclusion — that gender-distressed children as young as 8 should undergo irreversible medical interventions.

The last hope for change may rest with the Endocrine Society’s new president, Dr. John Newell-Price. Like Cass, he hails from the United Kingdom, which is swiftly moving towards a more evidence-based approach to aiding children who feel uncomfortable in their bodies. If he is committed to medical science and ethics, he’ll use this meeting to announce a new direction, one that prioritizes children’s health over activist demands.

Alternatively, the Endocrine Society can continue to put children at risk. If that occurs, Americans should disregard this once-prestigious institution. Judges should dismiss its legal briefs defending aggressive and experimental interventions for children. Politicians should reject its testimony against laws aiming to protect children. Physicians and patients should seek guidance elsewhere on critical issues regarding the support of vulnerable and confused children. Although it’s not too late for the Endocrine Society to change course, this is the final opportunity.

Roy Eappen
Roy Eappen
Roy Eappen, MD, is a practicing endocrinologist and senior fellow at Do No Harm.

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