May 9, 2023 – By Brad Jones / Epoch Times
A crowd of more than 50 people protested outside the annual conference of the Pediatric Endocrine Society in San Diego 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, carrying signs and shouting “biology not ideology,” “puberty blockers don’t stop suicide” and “kids cannot consent to puberty blockers,” among other chants.
Our Duty, an international support group for parents who oppose transgender ideology, led the “Rally for Evidence-Based Care” on May 6.
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.
The narrative pushed by transgender activists that these medical interventions and transgender surgeries prevent suicide in gender dysphoric youth is a “fallacy,” Friday said.
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.
Judd said she became more aware of this after the events of Jan. 6, 2020, and she realized she had become radicalized in her beliefs. This self-discovery and regret, she said, led her to detransition.
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.”
Abigail Martinez shed tears as Friday retold the story of how Martinez was bullied by social workers who told her to hold a funeral for her daughter, Yaeli, and affirm her as a son. When she hesitated to use her daughter’s preferred male name and male pronouns, Martinez lost custody of Yaeli, who ended up in a foster care group home, started taking testosterone, and later committed suicide.
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.
A parental rights activist who goes by the pseudonym Ben Richards for fear of retaliation, who is a local leader of the Dad Army—a national group affiliated with the Mom Army that “empowers men” to fight against child trafficking and the sexualization of children—and founder of a social media group called SoCal Parent Advocates group on social media, urged more parents and other supporters to “stand up and speak up” against the “trans medical industrial complex.”
“This is in every institution. It’s in the schools. It’s in the medical industry. It’s in the government. And they have made these systems to discourage people from speaking out for fear of reprisal,” he said. “For instance, in the medical industry, they encourage and monetarily incentivize these harmful, irreversible procedures on children. And we’re here united from all walks of life, standing up courageously saying this is not right, and this must stop now.”
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.
More research released by Acute Market Reports released last month indicates that North America holds at least half of the global market share for sex reassignment surgeries.
According to the Gender Mapping Project, there were only “a handful” of gender clinics for children operating in North America a decade ago, but there are now more than 400 involved in what has become a multi-billion dollar industry in the U.S. alone, even as parts of Europe move away from the “affirmative care” model.
The Pediatric Endocrine Society did not respond to an inquiry about its policies supporting so-called “gender-affirming care” for children preceding its weekend-long conference.
Posters made by detransition advocates who met outside of the annual Pediatric Endocrine Society conference held in San Diego, Calif., on May 6, 2023. (John Fredricks/The Epoch Times)
‘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.
In the United Kingdom, the Cass Review (pdf), chaired by Dr. Hilary Cass, a leading British pediatrician, linked the “lack of safeguards for children” at the Tavistock gender clinic London to the “affirmative model” of care which “originated in the USA.”
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.
An article published by the Society for Evidence Based Gender Medicine (SEGM) on April 18 points out that after assessing whether the benefits of youth gender transition outweigh the risks, public health authorities in England, Finland, and Sweden concluded they don’t, and have since revised their policies and practices to substantially restrict medical and surgical transitions of children and adolescents.
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.”
A review of the studies published April 14 concluded that “systematic reviews of evidence from Europe failed to demonstrate the hoped-for meaningful improvements in youth’s mental health functioning and exposed significant risks, including demonstrated risks to bone development,” and suggest doctors may have erred in their assessment of how to treat gender dysphoria in youth.
“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.”
But, in Democratic blue states such as California, the push for “gender-affirming care” among many progressive politicians has never been stronger, with several legislative bills passed over the last year to support the practice.
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.”
In March 2021, then PES President Madhu Misra issued a letter opposing pending legislation in Alabama, Arkansas, and other states that sought to ban puberty blockers and cross-sex hormone interventions for gender dysphoric children who identify as transgender.
“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.
The next month the PES released a position statement (pdf) denouncing legislation it described as seeking “to criminalize health care professionals who provide gender-affirming care such as pubertysuppressing medications and gender-affirming hormone therapy.”
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.”
Puberty blockers, such as Lupron—known to cause chemical castration—were first used to treat cancer. Doctors realized that because the drug worked to block the pituitary gland from producing testosterone in men with prostate cancer, it could also be used to stop the production of estrogen in young girls who experience puberty too early, according to Laidlaw.
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.”
A sign for the Food and Drug Administration is displayed outside their offices in Silver Spring, Md., on Dec. 10, 2020. (Manuel Balce Ceneta/AP Photo)
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.
“There is always a more honest answer to gender dysphoria than the chemical sterilization and surgical mutilation of what are otherwise very healthy young bodies and doing it all for what is a mental health issue that overwhelmingly desists by adulthood,” he said. “So why in the world would you permanently medicalize somebody for something that the odds are is going to go away?”
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.
Van Mol agrees with Laidlaw that the national debate will be decided in the courts through lawsuits as more health insurance companies, hospitals, doctors, pharmaceutical companies and biotech companies are sued by the people they’ve harmed.
“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.
Van Mol said Chloe Cole’s pending lawsuit against Kaiser Permanente could be “America’s Bell versus Tavistock” decision. Kiera Bell is a British detransitioner who brought a case against the now infamous UK clinic and increased public attention toward the issue.
‘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.
“Puberty is more than just a process of genital maturation. It is also a critical time for bone, pelvis, brain, and psychosocial development. All of these processes are adversely affected by puberty blockers. Studies have shown the effects on the pituitary are not immediately reversible,” Laidlaw wrote.
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.
Since then, other medical associations have “signed off” on the same or similar guidelines as WPATH’s controversial Standards of Care, Laidlaw 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.
WPATH also has been heavily scrutinized in British Medical Journal articles for its lack of qualitative evidence to support its recommendations.
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.
The San Diego protest is the latest in a series of recent Our Duty demonstrations in Anaheim, Sacramento, San Francisco, and Los Angeles, among other cities in California and other states.