This article originally appeared in the Washington Examiner.
By Roy Eappen, June 4, 2024
It’s not too late to turn back. That’s what the Endocrine Society, one of North America’s most powerful medical institutions, must remember as its annual meeting occurs in Boston this week.
The society is one of the foremost advocates of aggressive, invasive, and irreversible “gender-affirming” treatments for children. For years, it has played a major role in lawsuits that have struck down state laws protecting children, and judges, politicians, physicians, and patients look to it for guidance. Yet recent developments should cause the Endocrine Society to reconsider its stance for the sake of children.
I say this as a longtime endocrinologist who attended the society’s 2023 meeting in Chicago. My peers and I have long acknowledged the weak evidence supporting “gender-affirming” treatments for children.
The society itself has admitted as much since 2017, when it fully endorsed such treatments based on what it called “low” and “very low” quality evidence. The society also explicitly stated that it places a high value on children’s physical appearance yet has lower concern for potential medical harm to vulnerable young people. Based on these guidelines, endocrinologists in the United States and Canada broadly provide puberty blockers and cross-sex hormones to children, paving the way for eventual sex-change surgeries.
Yet since last year’s meeting, the Endocrine Society has come under sustained, and justified, pressure. Most notably, the United Kingdom’s Cass report, authored by renowned pediatrician Dr. Hilary Cass, criticized the Endocrine Society’s guidelines for “lack[ing] developmental rigour.” She concluded that there’s “no good evidence on the long-term outcomes” of the extremely aggressive (and largely experimental) treatments the society recommends.
Where, then, does the evidence point? Cass concluded that, as a general rule, “a medical pathway will not be the best way to manage [children’s] gender-related distress.”
The data prove it: At least 80% of children who think they’re transgender, and maybe as many as 94%, ultimately decide they aren’t. These children don’t need body- and mind-altering chemicals and surgeries that turn them into something they aren’t.
They need caution, counseling, and, most of all, time to come to grips with who they are. In other words, they need exactly what the Endocrine Society doesn’t endorse.
The question now is whether the Endocrine Society will change its tune and once again put children’s health first. The initial signs aren’t promising. It responded to the Cass report by appealing not to evidence but to emotion: “We stand firm in our support of gender-affirming care” on the basis that it’s “needed and often lifesaving.”
Such words show little concern for medical science and ethics on which true care depends. As Cass has noted in the wake of her report, groups such as the Endocrine Society are “misleading the public.”
The society has also launched its own review of the evidence, yet that doesn’t look promising either. The panel overseeing the review is stacked with physicians who have conflicts of interest, including several who are tied to an outright advocacy group, the World Professional Association for Transgender Health.
WPATH has a history of using the Endocrine Society as its mouthpiece, giving its extreme treatment demands a veneer of medical authority. WPATH also conducted its own review of the evidence, only to bury it when researchers found a lack of evidence. Given WPATH’s influence, the Endocrine Society looks set to reach a preordained conclusion — namely, that gender-distressed children as young as 8 years old should receive irreversible medical interventions.
The last hope for change may come from the Endocrine Society’s new president, Dr. John Newell-Price. Like Cass, he’s from the United Kingdom, which is rapidly moving toward a more evidence-based approach to helping children who aren’t comfortable in their bodies. If he’s committed to medical science and ethics, he’ll use the society’s meeting to announce a new direction, one that puts children’s health ahead of activist demands.
Or the Endocrine Society can keep endangering children. If that happens, Americans should ignore this once-prestigious institution. Judges should toss its legal briefs defending aggressive and experimental interventions for children. Politicians should reject its testimony against laws that protect children. And physicians and patients should look elsewhere for guidance on critical questions about how to help vulnerable and confused children. It’s not too late for the Endocrine Society to turn back, but this is the last chance.
Roy Eappen, MD, is a practicing endocrinologist and Senior Fellow at the Macdonald-Laurier Institute.
