128 - As Weird as a Chicken Crying: AAP Statement on Pediatric Gender Transition with Dr. Julia Mason
Aug 25, 2023
auto_awesome
Dr. Julia Mason, practicing pediatrician, discusses her relentless efforts to push AAP for evidence-based care in pediatric gender transition. They explore AAP's involvement, limitations of submitting resolutions, controversy surrounding pediatric gender transition, importance of independent systematic reviews, and concerns about current practices and hope for reversal.
The American Academy of Pediatrics (AAP) plans to conduct a systematic review of the evidence regarding transgender and gender diverse youth, which is a crucial step towards ensuring evidence-based care.
Physicians can play a role in advocating for evidence-based practices in transgender and gender diverse care by writing letters, engaging with local media, and raising awareness among colleagues.
The definition of affirmative care in the field of transgender and gender diverse care is being reevaluated, which may have significant implications for gender-affirming interventions and the balance between affirming gender identity and evidence-based outcomes.
Deep dives
The American Academy of Pediatrics reaffirms its position on affirmative care and launches a systematic review of evidence
The American Academy of Pediatrics (AAP) held its annual leadership conference and voted unanimously to reaffirm its 2018 statement on affirmative care. The AAP also announced plans to conduct a systematic review of the evidence regarding transgender and gender diverse youth. However, there are concerns about the potential bias and outcome of this review, as the AAP has been criticized for its lack of scrutiny in previous statements. It remains to be seen how the AAP will navigate the conflicting perspectives and evidence in the field of gender care.
Challenges in conducting a systematic review of evidence
The AAP's intention to conduct a systematic review of the evidence is an important step towards ensuring evidence-based care for transgender and gender diverse youth. However, the process and outcome of the review are uncertain, and there is skepticism about the AAP's commitment to change its guidelines if the evidence does not support current practices. It is crucial for the systematic review to be conducted rigorously and independently, with a diverse group of experts and stakeholders involved in the process.
The need for physician involvement and advocacy
Physicians who are concerned about the current state of transgender and gender diverse care can play a role in advocating for evidence-based practices. Writing letters to local organizations, engaging with local media, and raising awareness among colleagues are important steps. It is crucial to foster open dialogue and ensure a wide range of perspectives are considered in the development of guidelines and policies. Additionally, physicians can support organizations like SEGUM, which provide education, resources, and critical analysis of the existing research.
The challenge of defining affirmative care
One of the key issues in the field of transgender and gender diverse care is the definition of affirmative care itself. The AAP has indicated that the definition may evolve, which could have significant implications for the approach to gender-affirming interventions. The challenge lies in striking a balance between affirming an individual's gender identity and ensuring the best outcomes based on reliable evidence. Ongoing discussions and collaboration among healthcare professionals, researchers, and advocacy groups are vital to address these complexities.
Hope for change and future progress
While the landscape of transgender and gender diverse care is complex and navigating the path towards evidence-based practices may be challenging, there are signs of progress. Countries like Finland, Sweden, and Norway have altered their approaches to gender care, and there is a growing recognition of the need for unbiased review of the existing evidence. With continued advocacy, engagement, and a commitment to rigorous research, there is hope for positive change in the field of transgender and gender diverse care.
“We are making strong recommendations based on weak evidence,” a statement from practicing pediatrician, Dr. Julia Mason, about the basis of gender affirming care, which is the model of care currently backed by the American Academy of Pediatrics (AAP).
In this episode, Dr. Mason sits down with Sasha & Stella to discuss her relentless efforts towards charging the AAP to pursue a systematic review of the evidence behind gender affirming care. They discuss the series of events leading up to the AAP’s most recent article reaffirming their commitment to the affirmation model as laid out in the AAP’s policy statement published in 2018, but also announcing their authorization of a systematic review of the evidence. This decision on the part of the AAP comes long overdue in the wake of so many European organizations who have recently conducted their own reviews, all of which have resulted in abrupt shifts in the care protocols around gender transition.
