Raúl Labrador, who won his race for Idaho attorney general, talks with attendees at the Idaho GOP election night watch party at the Grove Hotel in Boise, Idaho, on Nov. 8, 2022. (File/Otto Kitsinger/Idaho Capital Sun)
Idaho Attorney General Raúl Labrador – along with South Carolina’s attorney general and officials from 19 other states – have accused the American Academy of Pediatrics of possible “violations of state consumer protection statutes” over its standards and recommendations for gender dysphoria care for children.
In a letter sent by Labrador on Tuesday, the attorneys general requested information detailing the academy’s evidence for its current recommendations for puberty blockers for gender dysphoria-diagnosed youth.
“Most concerning, AAP claims that the use of puberty blockers on children is safe and reversible,” Labrador’s office said in a press release. “This assertion is not grounded in evidence and therefore may run afoul of consumer protection laws in most states.”
Children with gender dysphoria “need and deserve love, support, and medical care rooted in biological reality,” Labrador said in the release.
“It is shameful the most basic tenet of medicine — do no harm — has been abandoned by professional associations when politically pressured,” Labrador said. “These organizations are sacrificing the health and well-being of children with medically unproven treatments that leave a wake of permanent damage.”
The American Academy of Pediatrics, an organization made up of 67,000 primary care pediatricians, voted in August to reaffirm its 2018 policy statement on gender-affirming care and authorized development of an expanded set of guidance for pediatricians.
The organization could not immediately be reached for comment.
But at the organization’s leadership conference last month in Itasca, Illinois, American Academy of Pediatrics CEO and Executive Vice President Mark Del Monte emphasized that the organization is confident that the principles presented in the original policy statement, “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents,” remain in the best interest of children, according to an Aug. 4 press release from the academy.
The decision to authorize a systematic review reflects the academy board’s concerns about restrictions to access to health care with bans on gender-affirming care in more than 20 states, according to the release.
In Idaho, the Legislature passed a law banning Idaho youth from receiving gender-affirming medications and surgeries. It was signed into law by Gov. Brad Little in April 2023.
The law makes it a felony punishable for up to 10 years for doctors to provide surgeries, puberty-blockers and hormones to transgender people under the age of 18. However, gender-affirming surgeries are not and were not performed among Idaho adults or youth before the bill was signed into law, the Idaho Capital Sun previously reported.
South Carolina’s law
In South Carolina, a law signed by Gov. Henry McMaster in May prohibited gender transition surgeries and hormones for anyone under the age of 18.
It also included one line barring the use of public funds “directly or indirectly for gender transition procedures,” which resulted in the Medical University of South Carolina deciding to end treatments for transgender adults too. The public university intends to phase all existing patients off any gender-transitioning medications by Jan. 31, which is what the law requires for anyone under 18.
Last month, the state chapter of the American Civil Liberties Union sued in federal court to block the South Carolina law.
It threatens imprisonment only for doctors who perform surgeries on minors, which Democrats and Republicans agreed wasn’t happening in the Palmetto State anyway.
Otherwise, enforcement would be triggered by complaints to South Carolina’s licensing boards. Under the law, doctors or other health care providers who prescribe puberty blockers or gender-transitioning hormone therapy to children risk losing their license.
What’s in the American Academy of Pediatrics guidelines?
As outlined in its policy statement, the academy encourages pediatricians to use a gender-affirmative care model when treating young patients. The model encourages pediatricians to recognize that:
• Transgender identities and diverse gender expressions do not constitute a mental disorder;
• Variations in gender identity and expression are normal aspects of human diversity, and binary definitions of gender do not always reflect emerging gender identities;
• Gender identity evolves as an interplay of biology, development, socialization, and culture; and
• If a mental health issue exists, it most often stems from stigma and negative experiences rather than being intrinsic to the child.
“Many medical interventions can be offered to youth who identify as (transgender and gender diverse) and their families,” the academy notes in its policy statement. “The decision of whether and when to initiate gender-affirmative treatment is personal and involves careful consideration of risks, benefits, and other factors unique to each patient and family.”
However, Labrador said treatments that suppress hormones or use puberty blockers may have adverse health effects to the patient, including interfering with neurocognitive development, compromising bone density and interfering with normal puberty experiences.
He said the treatments may cause “harm particularly egregious” to children who “grow out” of the condition by the time they are adults.
The chief medical officer for Planned Parenthood Great Northwest, Hawai`i, Alaska, Indiana, Kentucky said in an emailed statement that her organization condemns the letter sent by Labrador and that it undermines “the evidence-based practices of gender-affirming care.”
“The use of puberty blockers for youth, endorsed by the American Academy of Pediatrics, is safe, reversible, and critical for supporting the physical and mental health of transgender individuals,” Deborah Nucatola said in the statement. “This care is not only widely accepted by every leading medical organization but is also essential for ensuring that young people can make informed decisions about their bodies and futures. We need to prioritize compassionate, science-driven care over political rhetoric, ensuring that all individuals receive the respect and support they deserve.”
The American Academy of Pediatrics in its policy statement says that research shows that children who assert their transgender identity before puberty and who “know their gender as clearly and as consistently” as their cisgender peers benefit from the same level of social acceptance as those peers.
“More robust and current research suggests that, rather than focusing on who a child will become, valuing them for who they are, even at a young age, fosters secure attachment and resilience, not only for the child but also for the whole family,” the academy wrote in its policy statement.
But Labrador and the other state officials say they want more information on how the academy has come to those conclusions, especially when it comes to puberty blockers.
“The letter requests detailed information from the AAP regarding its communications and practices related to youth gender dysphoria and substantiation of the academy’s claims regarding the safety and reversibility of puberty blockers,” the attorney general’s press release says.
Other states joining Idaho in sending the letter to the academy include officials from Alabama, Arizona, Arkansas, Florida, Georgia, Iowa, Kansas, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, South Carolina, South Dakota, Texas, Utah, Virginia and West Virginia.
SC Daily Gazette Editor Seanna Adcox contributed to this report.
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Like the SC Daily Gazette, Idaho Capital Sun is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Idaho Capital Sun maintains editorial independence. Contact Editor Christina Lords for questions: info@idahocapitalsun.com. Follow Idaho Capital Sun on Facebook and X.