TUCSON, Ariz., June 14, 2016 /PRNewswire-USNewswire/ -- A new standard of care is being urged for the treatment of gender dysphoria in children despite a vigorous though suppressed debate among physicians, writes pediatrician Michelle Cretella, M.D., in the summer issue of the Journal of American Physicians and Surgeons. This treatment involves suppressing puberty, then prescribing cross-sex hormones.
Cretella points out that the vast majority, 80% to 95%, of children who feel there is a difference between their perceived gender identity and their genetically determined sex spontaneously align their identity with their anatomic sex after passing through puberty. She argues that psychology must return to the self-evident principle that persistent thoughts that run contrary to physical reality are objectively abnormal.
The belief that a person could have a masculinized or feminized brain trapped in the wrong body is based on ideology, not science, Cretella states. Neuroplasticity, however, is a real phenomenon. Experience and behavior can change brain microstructure; therefore "if and when valid transgender brain differences are identified, these will be more likely the result of transgender behavior than its cause."
There are no long-term controlled studies comparing the outcome of psychotherapy with that of pubertal suppression followed by decades of toxic synthetic steroids, Cretella notes. Beginning such treatment at an early stage (Tanner Stage II) of puberty will leave these children sterile and without the capacity to produce sperm or eggs for cryo-preservation, she warns. Yet there are 40 gender clinics in the U.S. promoting this.
The adolescent brain is immature, Cretella notes. Until reaching the mid-twenties, a young person likely lacks the ability to assess risk or to give fully informed consent.
"When an individual is sterilized, even as a secondary outcome of therapy, lacking full, free, and informed consent, it is a violation of international law," Cretella states.
Physicians who are concerned about potential long-term risks may hesitate to speak out for fear of losing their job, as a foremost authority and life-long advocate of transgender rights, Kenneth Zucker, did.
Hormonal treatment of gender dysphoria in children amounts to mass experimentation, Cretella concludes. "There is a serious ethical problem with allowing irreversible, life-changing procedures to be performed on minors who are too young to give valid consent themselves."
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
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SOURCE Association of American Physicians and Surgeons (AAPS)