The opinion of the Texas attorney general and a new Alabama law — both seeking to criminalize health care for transgender youth — are based on either blatant lies for political purpose or the use of outdated and discredited evidence, according to a panel of medical professionals who specialize in the care of gender dysphoria and pediatrics.
“The medical claims are not grounded in reputable science and are full of errors of omission and inclusion. These errors, taken together, thoroughly discredit the attorney general opinion’s claim that standard medical care for transgender children and adolescents constitutes child abuse. The Alabama law contains similar assertions of scientific fact, and these too are riddled with errors, calling into question the scientific foundations of the law,” the scholars declared.
“The medical claims are not grounded in reputable science and are full of errors of omission and inclusion.”
Their lengthy academic evaluation was released last week by the Child Study Center at Yale University School of Medicine.
In the same week, a separate study by researchers at Princeton University — part of the largest longitudinal study ever of transgender youth — found that very few children who declare themselves to be transgender later change their minds.
That study, reported in the journal Pediatrics, said children who declare themselves to be a different gender than the one assigned at birth seldom “retransition” back to their birth-assigned gender. In fact, of the 317 transgender children tracked in the study only 7.3% retransitioned at some point. But even then, at the end of the five-year period, 94% of the transgender children still identified as transgender, while 3.5% identified as nonbinary and only 2.5% returned to the single gender identity assigned at birth.
“These results suggest that retransitions are infrequent. More commonly, transgender youth who socially transitioned at early ages continued to identify that way,” the researchers concluded.
Meanwhile, the Yale researchers issued a rare public rebuke to elected officials. The doctors and researchers took sharp aim at Texas Attorney General Ken Paxton, the Alabama Legislature and Alabama Gov. Kay Ivey. The paper stops barely short of calling all those who perpetuate fear of transgender health care outright liars.
The paper stops barely short of calling all those who perpetuate fear of transgender health care outright liars.
The stakes in this battle are exceptionally high, as Republican politicians are working to deny health care for transgender children and teens and to make criminals of the physicians, counselors and parents who seek such care for them. Nowhere has this been more contentious than Texas, where the inflammatory legal opinion issued by the attorney general Feb. 18 led Gov. Greg Abbott to call medical care for transgender minors “child abuse” and to ask other state agencies to immediately investigate anyone found to be engaged in such.
Transgender identity has become the latest flashpoint in Republican and conservative evangelical tactics to generate outrage in the nation’s culture wars, even though transgender persons represent less than 1% of the population and are considered among society’s most vulnerable persons.
Part of the debate over so-called Critical Race Theory involves attempts to censor awareness of transgender identity, and multiple state legislatures have passed bills this year to outlaw transgender students participating in competitive athletic events — even though the instance of such participation are miniscule.
Ken Paxton
The actions of the Texas attorney general and governor have been cited as influencing the highly controversial decision of the University of Texas Southwestern Medical System to close its acclaimed transgender care clinic. Even though top administrators of the medical school say they were under no pressure from the attorney general or governor, news of the closure came just days after Abbott’s order and doctors working in the clinic have said there was a direct link. One has filed a lawsuit to prove it.
UT Southwestern is part of the state university system and therefore susceptible to state politics. It is the largest medical school in the state and has trained thousands of physicians who practice across Texas.
Among the seven authors of the new report is one faculty member at UT Southwestern, Laura Kuper, assistant professor in psychiatry.
Other authors include Susan D. Boulware, associate professor of clinical pediatrics at Yale School of Medicine and medical director of the Yale Pediatric Gender Program; Rebecca Kamody, assistant professor at Yale School of Medicine; Meredithe McNamara, assistant professor of pediatrics at Yale School of Medicine; Christy Olezeski, associate professor of psychiatry at Yale Child Study Center and director of the Yale Pediatric Gender Program; Nathalie Szilagyi, instructor in the Yale Child Study Center and director of the Greenwich Center for Gender and Sexuality; and Anne Alstott, law professor at Yale Law School.
This all-star academic lineup minces few words in debunking the legal opinions of Paxton and the Alabama Legislature.
This all-star academic lineup minces few words in debunking the legal opinions of Paxton and the Alabama Legislature.
Among their key findings:
Paxton’s opinion and the Alabama law “falsely claim that current medical standards authorize the surgical sterilization of transgender children and adolescents. In fact, present medical standards state that individuals must be the age of majority or older before undergoing surgery on genitals or reproductive organs.”
Paxton’s opinion and the Alabama law “ignore the substantial benefits of medical care for transgender children and adolescents, care which has consistently been shown to reduce gender dysphoria and improve mental health. The best scientific evidence shows that gender dysphoria is real, that untreated gender dysphoria leads predictably to serious, negative medical consequences, and that gender-affirming care significantly improves mental health outcomes, including reducing rates of suicide.”
Paxton’s opinion and the Alabama law “greatly exaggerate the risks of gender-affirming drug therapy.”
Their focus, the researchers say, is not on the legality of the Texas and Alabama measures but on the medical facts — especially the “facts” misrepresented by these government officials.
“These are not close calls or areas of reasonable disagreement,” they state. “The attorney general opinion and the Alabama law’s findings ignore established medical authorities and repeat discredited, outdated and poor-quality information. The attorney general opinion also mischaracterizes reputable sources and repeatedly cites a fringe group whose listed advisors have limited (or no) scientific and medical credentials and include well-known anti-trans activists.”
“These are not close calls or areas of reasonable disagreement.”
And the list goes on to cite other examples of shoddy or discredited research included in Paxton’s opinion. These include errors of omission, which present at “warped picture of the scientific evidence.”
“The repeated errors and omissions in the attorney general opinion are so consistent and so extensive that it is difficult to believe that the opinion represents a good-faith effort to draw legal conclusions based on the best scientific evidence,” the doctors state. “It seems apparent that the attorney general opinion is, rather, motivated by bias and crafted to achieve a preordained goal: to deny gender-affirming care to transgender youth. The same is true of the scientific claims made in the Alabama law.”
Related articles:
Why being transgender is not a sin | Opinion by Mark Wingfield
Texas officials’ new attack on transgender care called a ‘political ploy’ at the expense of children