Big news! The American Academy of Pediatrics (AAP) published a policy statement in support of trans kids today and it is TRULY supportive! I was able to read it a few days ago & have been dying to talk about it because it’s THAT good. Here’s a thread with some of the best stuff:
First, a reminder of who we're talking about: the American Academy of Pediatrics (AAP) is a body of roughly 67,000 physicians who work with children. It's a longstanding and credible body, using fact-based findings to shape its policies.
In contrast, the deceptively named American College of Pediatricians (ACP) has only a few hundred members (doctors and others) and has been designated a hate group. You may have seen their video on puberty blockers circulating around.
We’re talking about the AAP today, not the ACP (phew!) The AAP’s recommendations help shape medicine for kids around the world, so this policy statement actually *means something*. That’s why I’m so excited.
Here's the link to the full doc: http://pediatrics.aappublications.org/content/early/2018/09/13/peds.2018-2162 …
First, the AAP wants you to know – like, truly get – that being trans/gender diverse does NOT constitute a mental disorder. No way, no how. Not even close. To emphasize this, they quote directly from the American Psychiatric Association:
“Being transgender or gender variant implies no impairment in judgment, stability, reliability, or general social or vocational capabilities” – American Psychiatric Association, 2012. So, no, being trans is NOT a mental illness. (Duh.)
Both the AAP and APA recognize being trans/gender diverse in our society is hard, however, and the discrimination/marginalization faced by this community can be damaging to a person’s mental health.
Discrimination is the issue, NOT being trans.
Why is this important? Because it shows how conversion/reparative therapy would be grossly ineffective for TGD kids and, uh, SUPER damaging. The AAP makes sure to mention this. (We shouldn’t have to say that in 2018, but here we are.)
Okay. THIS. IS. HUGE.
“Research substantiates that children who are prepubertal and assert an identity of TGD know their gender as clearly and as consistently as their developmentally equivalent peers who identify as cisgender”
In other words, listen to what a child is saying about their own gender no matter how old they are. There’s no magic age when they suddenly become more credible. They don’t need to be teens to be believed. This whole "watchful waiting until they're old enough" approach is a nope.
But what about those “desistance” studies showing 80% of kids grow out of it?
Well, the AAP agrees with most people who’ve looked at those studies and finds they have “validity concerns, methodologic flaws, and limited follow up on children who identified as TGD”
Medical support for trans youth is becoming more progressive, too!
Puberty blockers: Tanner stage 2-5 (same as before)
Cross-sex hormones: Early adolescence onward
Gender-affirming surgeries: Typically adults AND adolescents on a case-by-case basis
This is great because, if guidelines are followed, teens won't have to wait as long to access hormones or surgery. (Aside: my own daughter started estrogen at 14 and being able to start puberty around the same time as her peers instead of waiting to 16+ was so good for her.)
The AAP does recognize more research is needed on the affects of long-term blockers but provides much evidence to support its use in trans youth (positive mental health outcomes, etc). Like most medical treatments, risks assessments are done. That’s not exclusive to trans kids.
Here’s a non-shocking finding:
“Supportive involvement of parents and family is associated with better mental and physical health outcomes. Gender affirmation among adolescents with gender dysphoria often reduces the emphasis on gender in their lives...
“… allowing them to attend to other developmental tasks, such as academic success, relationship building, and future-oriented panning.”
In other words, affirming trans youth is NOT child abuse. Far from it. It's one of the biggest accusations made against parents & it's wrong.
There’s a big section on school life, too. In a survey of younger trans kids (K-grade 8),
“54% were verbally harassed, 24% were physically assaulted, and 13% were sexually assaulted; 17% left school due to maltreatment.”
That’s heartbreaking, but sadly unsurprising.
BUT! According to a 2015 GLSEN study, LGBTQ kids reported safer school environments, less hostility and fewer absences due to bullying when LGBTQ people were positively represented in the curriculum.
Exposure and comprehensive sex and health education are so important.
Anyway, there’s a ton of stuff in the new guideline along with all the studies to back it up.
As an affirming parent, it validates a lot of what we’ve been doing with our trans daughter for the last 4+ years. The proof is in science and in our household. Well done, AAP!
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