The Hidden Motivation For The AMA's Change Of Heart About Transgenderism

The amount of positive news that I have had the pleasure of reporting to you in recent months is quite astonishing. It is giving me hope.

Last week, I told you about how pro-euthanasia and assisted suicide measures are stalling in several nations in Europe, as opponents are raising significant concerns about how such laws have been abused in other nations, and how there are dignity-protecting options that provide authentically loving support for those facing end-of-life situations and dilemmas, e.g. better palliative care.

Now, this week I can report a remarkable new development in the fight against radical gender ideology.

ASPS and AMA: Transgender Surgeries not Supported by Evidence

For years, we have been told by “the experts” that so-called “gender-affirming care” for youth was driven by compassion, backed by evidence, and guided by sober medical judgment. And for years, anyone who raised serious questions was, at a minimum, assured that the “science is settled.”

More often, however, we were accused of being bigots who posed a threat to the very lives of individuals identifying as transgender, if we so much as raised a doubt about the idea of helping young people “transition” by chopping off parts of their bodies, or putting them on life-long doses of extremely potent, life-altering drugs.

This past week, that story took a hit… to put it mildly.

In the past few days, two of the largest and most-influential American medical organizations released statements endorsing significant limits on surgical interventions for minors intended to help them transition to the “opposite gender.”

In their lengthy statement, released February 3, the American Society of Plastic Surgeons (ASPS) said such surgeries should be delayed until at least age 19.

This was followed by the American Medical Association (AMA), the single most influential medical body in America, putting out their own statement agreeing with the ASPS.

“In the absence of clear evidence, the A.M.A. agrees with A.S.P.S. that surgical interventions in minors should be generally deferred to adulthood,” said the AMA.

One of the striking things about the ASPS position statement is how openly it acknowledges how scientifically unfounded efforts to “treat” gender dysphoria through surgical interventions really are.

The ASPS notes that the clinical management of children and adolescents with gender dysphoria “has undergone rapid change,” and that recent evidence reassessments have found “limitations in study quality, consistency, and follow-up,” alongside “emerging evidence of treatment complications and potential harms.”

That is a polite way of saying something blunt: the medical community moved quickly, while the evidence base stayed thin. And children paid the price.

A Radical Change

It is hard to overstate just how radical a development this is.

In many progressive leftist circles, it has long been an established orthodoxy that one must never question the validity of so-called gender “treatments.” The news is stacked with stories of individuals who have been hounded out of polite society, merely because they wondered whether the data really did support such drastic interventions for something (i.e., gender dysphoria) that research has consistently shown most youth will naturally grow out of.

The case of J.K. Rowling is highly instructive. Once considered one of the leading lights in progressive spheres, a self-declared and proven feminist through and through, she has in recent years been subject to vociferous efforts at cancellation by leftists. Through it all, she has been hounded on social media to a degree that is difficult to fathom.

And all of this is because she has raised concerns about subjecting children to such radical procedures, and for pointing to the many negative consequences that follow from denying so thoroughly scientifically-supported a reality as binary sex in human beings.

And now, two medical organizations that have a long track record of bowing the knee to progressive orthodoxy have publicly taken positions that validate what so many sane people have known since the beginning.

It is very difficult at this point to refrain from saying “I told you so.” While the ASPS statement is a new development, the research showing that gender dysphoria in youth tends to be transient and self-resolve if left alone has long existed. It should never have taken this long for medical associations like the ASPS to publicly recognize this fact.

Note how sweeping the ASPS statement is. It does not merely recommend “more careful screening.” It does not say, “Proceed, but do it better.” It concludes there is “insufficient evidence” for a “favorable risk-benefit ratio” for the pathway of endocrine and surgical interventions in children and adolescents. Period.

As the statement goes on to note, pediatricians have no way to differentiate between those youth who will recover from gender dysphoria without intervention from those who may experience persistent distress. However, by treating every troubled youth as if their gender dysphoria is a life sentence, gender ideologues are causing irreparable harm to unknown numbers of youth who would have gone on to have a perfectly normal, healthy relationship with their given sex, if left alone.

As the ASPS points out, the stakes are extremely high in these so-called gender “treatments.” Such interventions can, “permanently shape sexual function, fertility, embodiment and future medical needs.” That is to say, body parts that are cut off cannot be put back on. And the fertility that such procedures destroy cannot be restored. And the need for life-long medications to manage the consequences of these procedures cannot be reversed.

In a world where youth need to get parental permission to take Tylenol at school, it is nothing short of madness that we have gone through a decade in which countless youth have been fast-tracked towards irreversible interventions, based upon non-existent medical evidence.

A False Autonomy

Defenders of youth transition medicine have leaned heavily on the language of “autonomy.”

If a teenager “knows who they are,” we have been told, then adults – parents and physicians – are told they must “affirm” that knowledge, even with permanent interventions. To do anything less, it was commonly asserted, would be to push vulnerable children suffering from gender dysphoria towards suicide.

ASPS directly challenges this framing. It notes that autonomy does not obligate physicians to provide interventions “in the absence of a favorable risk–benefit profile,” especially when decision-making capacities are still developing.

Boy with gender dysphoria looking in mirror
ASPS also warns surgeons not to treat upstream referrals as a substitute for their own judgment. “A prior medical intervention, referral, or letter of support” is not a proxy for readiness or indication, the statement says, because surgeons retain an “independent professional responsibility” to assess risk-benefit amid uncertainty.

This is a quiet rebuke of a system that, in many places, has functioned like a conveyor belt.

The reality is that teenagers suffering with gender dysphoria, and often under the influence of radical ideologues on social media or at school, are simply unequipped to consent to the drastic, life-altering consequences of “gender-transition” surgeries. How can a 16-year-old possibly understand what it means to give up his or her fertility, for life, because of feelings that may well resolve on their own, if left alone?

That’s not authentic autonomy.

A Hidden Motivation

But, lest one think that the ASPS and AMA have had a sudden change of heart, and are sincerely motivated by purely scientific considerations, it is worth considering something else that has changed in recent years: people, now adults, who were subjected to experimental and life-altering transgender interventions as youths, are now taking their doctors and hospitals to court.

And they’re winning.

The field of so-called “transgender healthcare” has been rattled by dozens of lawsuits filed by people who regret the procedures they underwent as teenagers. Last week, a jury in New York awarded $2 million to a woman who said a teenage mastectomy left her disfigured.

Fox Varian was just 16 when surgeons performed a double mastectomy. As Yahoo News reports, “On Jan. 30, a New York jury found two medical professionals involved in Varian’s case liable for malpractice, saying they had skipped key steps when determining whether irreversible surgery was the best course of action.”

Advocates for those harmed by surgical and medical interventions for gender dysphoria predict that the floodgates have now been opened. Many millions of dollars in payouts will be made to people who were fast-tracked to life-altering procedures by unscrupulous doctors and ideologues.

HHS Welcomes Developments

Noteworthy is the response from the federal government to the new medical statements.

In a February 3 press release, HHS leaders praised the plastic surgeons for “disavowing pediatric sex-rejecting procedures.” Secretary Robert F. Kennedy, Jr. said ASPS was “defending sound science” and helping protect children from “irreversible harm.”

Deputy Secretary Jim O’Neill called it “another victory for biological truth.” While Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz compared pediatric “sex-rejecting procedures” to lobotomies in terms of how future generations might judge them.

One of the first things that the Trump administration did was reverse all of the Biden administration’s misguided executive orders on gender ideology.

While some consider many things that the Trump administration has done to be less than popular, the efforts to rein in gender ideologues has generally been met with comparative silence or approval.

The reason for this is quite simple: most ordinary people, including many self-described liberals, think that the idea of performing irreversible surgical or medical procedures on children who are completely unequipped to understand or consent to such drastic interventions is moral madness.

Similarly, many parents of all political stripes are increasingly disturbed at the way the ideologues are running roughshod over common sense in relation to things like sports and sex-segregated spaces. It turns out that moms and dads of girls aren’t thrilled at the idea of their daughters competing against biological males or sharing intimate spaces with members of the opposite sex.

The Prophetic Clarity of Catholic Anthropology

In comments reported by EWTN, Dr. Alfonso Oliva, a board member of the Catholic Medical Association, welcomed the ASPS statement, saying that “it goes a long way to try to protect adolescents from harm.” He added that, in his view, it should go further, arguing for postponing such surgeries until age 25, when “the young adult brain is completely formed.”

Dr. Oliva also highlighted what clinicians have been reluctant to admit publicly: it is “almost impossible” to predict which adolescents will persist in dysphoria and which will desist, and that “most adolescents who have gender dysphoria will over time, on their own, desist.”

It “makes more sense to treat them through psychotherapy primarily, rather than irreversibly change their physical biology,” especially given the consequences for sexual function and reproduction.

This is common sense. However, from the Catholic perspective, it’s not only common sense, but also a reflection of a deep anthropology that looks prophetic in the light of these recent developments.

The Church has always insisted that the human person is a unity of body and soul. The body is not raw material for self-invention. Sexual difference is not an imposition, nor is it random. It is a gift inscribed deeply in the body, ordered toward communion and fruitfulness.

No number of superficial, albeit radical, interventions can erase the sexual differentiation that is infused into every cell of the human body, and which is reflected in the consciousness of the sexed human person. The very effort is nothing short of a diabolical rejection of the givenness of the body and of sex, in an insane, and ultimately doomed, Promethean effort to re-make reality.

This is why Pope Francis warned so often about “gender theory” and its effects on children. During his Pontificate, he frequently singled out gender ideology for criticism, as when he exclaimed to the Polish bishops, “Today children – children! – are taught in school that everyone can choose his or her sex. Why are they teaching this?”

Not Enough

These developments do not end the debate. They do, however, mark a turning point.

We can be grateful for a backlash when it protects children. We can also be honest about why it happened. Extremist progressives pushed too far. And some of them are about to pay the price, in lost lawsuits, and massive malpractice payouts.

Reality has been pushing back for some time. This week, it pushed back loudly.

However, it isn’t enough. Not nearly enough. These statements only disavow surgical interventions. They needed to be extended to so-called “medical” interventions – i.e. those employing powerful drugs – which can have many of the same, long-long, negative impacts as surgical procedures, such as lifelong infertility.

The question now is whether our institutions will have the humility to follow where evidence and ethics lead – or whether they will keep trying to silence the truth until the next jury verdict forces them to listen.

Fr. Shenan J. Boquet is the president of Human Life International and a leading expert on the international pro-life and family movement.