The American Academy of Pediatrics (AAP) has been accused by some of its own members of blocking discussions about a resolution asking for rigorous systematic review over gender-affirming care guidelines. At issue is 2018 guidance which states children can undergo hormonal therapy after they are deemed appropriate candidates following an evaluation in mental health; however, there’s no mention if this includes those who identify as trans or aren’t satisfied with their assigned sex at birth.The five members of the AAP, which has a membership across North America with around 67,000 pediatricians writing for its journal, have called for an update to the guidelines in order to better protect patients. They acknowledge that there may be risks involved but also point out these can always be managed by careful follow up care from doctors, and coordination of care within the medical field is key.Critics say minors under age 18 may get fast-tracked too quickly or inappropriately and end up regretting their decision.

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The members of the AAP are in an acrimonious dispute when it comes to debate on their website. The organization’s leadership has been accused by many for changing resolutions rules and biased editing practices that allow only one side room for discussion, despite being publicly accessible forums with ample space available online for comment.Some members have accused the AAP of deliberately silencing debate on this issue. Any member can submit a resolution for consideration by group leadership at their annual policy meeting, but now those submitting such papers, unsponsored, will not be allowed to comment or raise opposing points of view—a move that one expert says may alter how debated topics are crafted in the future.The CEO of the agency, Mark Del Monte, has said that they were unable to get sponsorship for Resolution 27 at this past year’s annual leadership forum. The reason given was that there have been policy changes made every year and that there wasn’t any specifically associated with the current debate about transgender youth.However, one of the resolution’s authors said there was sponsorship when members first drafted this suggestion. Julia Mason from Gresham Oregon describes herself as a pediatrician in private practice and board member at Social for Evidenced Based Gender Medicine (SEGM) who attended an AAP chapter meeting where she claims an AAP chapter president had agreed on seconding Resolution 27 but backed off after attending another event. Mason did not name any specific person or group responsible.“I’m concerned that kids with a transient gender identity are being funneled into medicalization that does not serve them,” Mason said. “I am worried that the trans identity is valued over the possibility of desistance,” she added, admitting that having fewer children transition gender is her goal.Last summer, AAP found itself in hot water on the same topic when it barred SEGM from having a booth at the AAP annual meeting in 2021.

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Pediatricians at Odds Over Gender-Affirming Care for Trans KidsPediatricians clash with own professional group over policy for treating trans youth