State crackdowns on 'gender affirming care' for kids parallel heated debates within medicine

As states investigate and crack down on rushing gender-confused children onto puberty blockers and cross-sex hormones, a Freedom of Information Act lawsuit seeks federal data that could undermine the Biden administration's push on so-called gender affirming care.

The debate over when and how to medically transition children is becoming increasingly acrimonious within the political left, including disagreements on the rigor of research claiming that rushed transitions are necessary to prevent suicide.

Former Trump White House adviser Stephen Miller's America First Legal sued the Food and Drug Administration Feb. 27, alleging nonresponsiveness to AFL's Sept. 29 FOIA request for records from Biden's inauguration to date related to off-label use of puberty blockers and cross-sex hormones for children.

The request asked for records that included the terms "child" or "minor" and "puberty blocker," the drugs Lupron, Leuprorelin, Fensolvi, Synarel, Nafarelin, Supprelin, Vantas, Triptodur and Histrelin and the drug classes GnRH agonist or GnRH analogues.

Th AFL complaint asked the federal court in D.C. to order the FDA to "conduct searches immediately" and show their search methods were "reasonably likely to lead to the discovery of responsive records" and to award AFL attorney's fees.

The FDA declined to tell Just the News if it had responded to the records request beyond confirmation of receipt.

The FDA added a warning to GnRH agonists last summer because of their "plausible" connection to spontaneous increases in intracranial pressure in girls. Kaiser Health News reported as early as 2017 that Lupron could cause "lasting health problems."

The Republican governors of South Dakota, Mississippi and Tennessee all signed bills into law in the past month that prohibit gender affirming procedures for minors. 

The most recent, in Tennessee, provides for investigations of medical providers by the attorney general and $25,000 penalties for violations. Treatment begun before July 1 and ended by March 31, 2024 is exempt. 

The legislation was prompted by once-public videos from Vanderbilt University Medical Center that feature its employees calling gender clinics financially lucrative, both surgeries and ongoing drug treatments, and warning that resistant employees would face "consequences" for not participating. 

Missouri's Washington University and BJC Healthcare refused to halt what they called "critical, standards-based care to current and new patients" amidst an investigation of their transgender health center at St. Louis Children's Hospital prompted by whistleblower Jamie Reed.

But they told Missouri Attorney General Andrew Bailey they were instituting unspecified "additional oversight" at the clinic, the St. Louis Post-Dispatch reported in mid-February. Missouri lawmakers and Sen. Josh Hawley (R-Mo.) are pushing state and federal legislation to prohibit such treatments for minors, and Hawley also issued a preservation demand letter to the hospital.

A British Medical Journal investigation last month said that "concerns about the rapid widespread adoption of interventions and calls for rigorous scientific review [of pro-transition research] are coming from across the ideological spectrum" and among gender identity professionals.

It cited research on rising numbers of mostly female "adolescents with no history of gender dysphoria" presenting at gender clinics, their "concurrent mental health and neurodiverse conditions" compared to minors without gender confusion, and estimated detransition rates of 20-30%.

BMJ contrasted American practice, which heavily favors medicalization from a young age, with the countervailing practices of Europe, Australia and New Zealand. England's National Health Service has gone so far as describing prepubertal gender dysphoria as a "transient phase" for most minors and warning that even social transition without a medical component has risks. 

The New York Times is following "the lead of far-right hate groups" in its coverage of transgender issues, according to a February open letter signed by more than a thousand self-identified Times contributors and several current staff.

It denounces reporters Emily Bazelon and Katie Baker by name for deeply reported features on internal divisions in the medical community on gender affirming care and the tradeoffs when schools hide social transitions from parents.

In a coordinated effort, a coalition led by GLAAD released a similar missive signed by celebrities, including comedy producer Judd Apatow and actress Lena Dunham. It blasts the Times for "platforming lies, bias, fringe theories, and dangerous inaccuracies" throughout "more than a year of irresponsible, biased news and opinion pieces about the transgender community."

Times editors responded to the internal denunciations by telling the newsroom they "will not tolerate" staff participating "in protests organized by advocacy groups or attacks on colleagues" in public forums, which violates the newspaper's ethics policy, Vanity Fair reported. 

That led to dueling efforts between the New York Times Guild, which said letter-signers were criticizing the "hostile working environment" created by Times transgender coverage, and dozens of Times staff, including high-profile reporters who defended their accused colleagues.

The letter organized by reporter Jeremy Peters accused union leadership of undermining their "ethical and professional protections" by seemingly endorsing "a workplace in which any opinion or disagreement about Times coverage can be recast as a matter of 'workplace conditions.'" This crosses the line between journalism and activism, they said.