[Doctorfever]

https://nationalpost.com/opinion/maj...affirming-care

Opinion column.

Recently, two major American medical groups endorsed age restrictions on gender-related surgeries, marking a dramatic shift in a debate long dominated by claims of consensus. First, the American Society of Plastic Surgeons (ASPS) issued a policy statement firmly opposing “gender-affirming” surgeries for people under 19. Then, the American Medical Association (AMA) signalled its support. These pivots deal a significant blow to Canadian activists and politicians who rely on the supposed professional consensus to defend these highly contested, unproven treatments for youth.

The ASPS, the professional association that represents the majority of plastic surgeons in the U.S. and Canada, now recommends that “surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.” The group cites the numerous systematic reviews conducted in recent years that have all found only low to very low quality evidence to support these interventions. This development is highly relevant for Canada, given that national data confirms that these surgeries have already been performed on hundreds of minors.

After more than a decade of the field of pediatric gender medicine being guided by ideological narratives, the nine-page ASPS statement is a veritable breath of fresh air — a much-needed return to respect for evidence-based medicine, developmental science and the traditional ethical principles of beneficence (promoting health) and non-maleficence (avoiding harm). It’s a timely one, too, coming just days after a jury in New York State awarded a young woman $2 million in damages for a “gender-affirming” mastectomy performed on her as a teenager, which she said left her disfigured. Other malpractice cases of this kind are currently moving through U.S. courts.

Importantly, the ASPS statement draws a sharp distinction between breast reduction or gynecomastia surgery (to reduce enlarged male breast tissue), which treat physical conditions, and “gender-affirming” mastectomies or breast implants, which rest on predicting future identity and shifting “embodiment goals.”

Undoubtedly, this course correction will be difficult. Innocent young people have been, and continue to be, harmed because every major medical association abandoned scientific and ethical principles, instead allowing small activist committees to craft policy based on ideology rather than evidence. This resulted in a cascade of confusion, with governments, media, well-meaning citizens and, worst of all, parents of trans-identified youth trusting that the experts were relying on solid science when they were relying on solid science when they were not.

The truth is that wilful blindness has always been the essential ingredient in this scandal. It can only continue as long as everyone agrees not to look too closely. Nowhere is that more evident than in Canada, where, aside from Alberta, the experiment marches on unabated. When Canadian medical associations finally find the courage to do what the ASPS has done and subject this protocol to genuine scientific scrutiny, there will be only one possible conclusion: it cannot be allowed to continue.