Having evaluated hundreds of children with disabilities, I support quality and nondiscriminatory education and treatment of all students. The 2021 Virginia Department of Education Model Policies for the Treatment of Transgender Students put this at risk. Virginia Beach school officials are wise to consider an alternative set of policies.
The 2021 policies enable school personnel to initiate gender-affirming care without parental awareness. Gender-affirming care begins by socially transitioning a child from a boy to girl or vice versa. This is followed by puberty blockers, cross-sex hormones and various surgeries. The treatment causes infertility and other irreversible health issues. The 2021 policies presume gender-affirming care is best for all students who say they wish to identify by something other than their sex.
No gender dysphoric child should be harmed by unaccepting parents. But our desire to protect children should not give schools permission to end-run parents when potentially life-changing issues are at stake.
Informed consent is a legal requirement of ethical health care. Minors are generally considered incompetent to provide informed consent because they are not sufficiently mature to weigh the potential risks and consequences of treatment options. Because gender-affirming research is still in its infancy, nobody can predict the full consequences of transgender care. Name changes, hormone therapy and sex-reassignment surgeries never completely transition a person from one sex to another. But the process always entails adverse health consequences and creates lifetime dependency on medications.
Dr. Miriam Grossman, a child psychiatrist who has cared for gender dysphoric individuals for decades, says puberty blockers sometimes trap kids into permanent gender-identity crises. Yet, the 2021 VDOE policies encourage school personnel to adopt whatever names and pronouns students prefer, thereby initiating gender-affirming care … without parental awareness or informed consent.
Grossman’s book, “Lost in Trans Nation,” details how the American Academy of Pediatrics has co-opted rank-and-file pediatricians into providing gender-affirming care despite most pediatricians disagreeing with the organization’s recommendations. Worse, the AAP guidance holds sway over educational policies despite its lack of adequate empirical support.
While attending Georgetown University’s recent PharmedOut conference, transgender care was raised during a session on hormone replacement therapy for menopausal women. An expert on harms associated with menopause-related hormone therapy noted that gender-affirming care involves larger hormone doses and more serious side-effects.
Gender dysphoria has existed for eons. Until recently, it affected less than 1% of humans. Even if more people have struggled with transgender issues than medicine has appreciated historically, the current epidemic most likely reflects a social contagion partially fueled by social media. So, when young adults express gender dysphoria, wouldn’t it be prudent to examine the forces driving their transgender desires before helping them transition?
As the debate roars, people should learn about Dr. John Money, the psychologist who coined “gender role” and founded the Gender Identity Clinic at Johns Hopkins. While there, Money fabricated evidence to convince the scientific and medical communities that one’s gender identity was wholly malleable. As told in “As Nature Made Him: The Boy Who Was Raised as a Girl,” Money’s opinions served as the cornerstone for AAP guidance advocating for immediate sex-change operations for children born with ambiguous genitalia (intersex babies).
Despite mounting scientific evidence that gender is not entirely socially constructed (biology matters), the AAP continued to promote sex-change operations among intersex babies. AAP amended its position only after David Reimer, one of Money’s ex-patients, exposed the doctor’s scientific fraud and child abuse. Reimer said, “I hope people learn from it that you don’t do something that dramatic to someone without their informed consent.”
If we don’t think schools should make parents aware of their children’s transgender struggles, should they alert parents when students are suicidal? If they skip school or become violent? What if they threaten to harm others?
As a health care researcher, I am aware of the extent to which corporate interests drive medical policies and clinical guidelines. Big egos, big money, and Big Pharma are influencing how we think about transgender issues. Nonetheless, our transgender school policies must promote both nondiscrimination and parental involvement. This is essential for the health and safety of all children.
Gretchen LeFever Watson, Ph.D., of Virginia Beach, is a clinical psychologist and an academic affiliate of the University of South Carolina.
