In a significant pushback against sex change operations in children, a group of pediatricians and other healthcare professionals from medical organisations across the U.S. have signed the 'Doctors Protecting Children Declaration'.

The declaration, authored by the American College of Pediatricians (ACPeds), has already been co-signed by various medical and health organizations across the U.S.

The signatories of the Declaration have called on prominent American medical institutions to stop the current harmful protocols recommended for children and adolescents who experience discomfort with their biological sex.

The Declaration calls on “the American Academy of Pediatrics, the Endocrine Society, the Paediatric Endocrine Society, the American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to adhere to evidence-based research and utilise comprehensive evaluations and therapies for youth with gender dysphoria".

Gender dysphoria refers to a condition where an individual experiences discomfort or distress due to a mismatch between their biological sex and their gender identity.

"As physicians, together with nurses, psychotherapists and behavioural health clinicians, other health professionals, scientists, researchers, and public health and policy professionals, we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex," the document said.

The declaration affirms that sex is a dimorphic, innate trait defined in relation to an organism’s biological role in reproduction.

The declaration stated that in humans, primary sex determination occurs at fertilisation and is directed by a complement of sex-determining genes on the X and Y chromosomes. It added that this genetic signature is present in every nucleated somatic cell in the body and is not altered by drugs or surgical interventions.

"Consideration of these innate differences is critical to the practice of good medicine and to the development of sound public policy for children and adults alike," the document said.

The declaration also stated that 'Gender ideology', which posits that sex (male and female) is insufficient and suggests further categorisation based on an individual’s thoughts and feelings, termed "gender identity" or "gender expression," fails to acknowledge the reality of these inherent sex differences.

The document asserted that this perspective leads to the incorrect notion that children can be born in the wrong body. It further stated that gender ideology aims to validate thoughts, feelings, and beliefs through measures such as puberty blockers, hormones, and surgeries, which can harm healthy bodies instead of affirming biological reality.

"Medical decision making should not be based upon an individual’s thoughts and feelings, as in “gender identity” or “gender expression”, but rather should be based upon an individual’s biological sex," it said.

The declaration highlights that the majority of children and adolescents whose thoughts and feelings do not align with their biological sex typically resolve those incongruencies after experiencing normal puberty. It references studies indicating high desistance rates among gender dysphoric children, suggesting that medical interventions may not be necessary or beneficial in many instances.

The declaration further critiques the current medical protocols in the U.S. for gender dysphoria, contending that they are founded on flawed research and can pose harm. It expresses apprehensions regarding the enduring consequences of social affirmation, puberty blockers, cross-sex hormones, and surgeries on both physical and mental health, including potential sterility and other significant risks.

The declaration urges medical professional organisations in the United States to adhere to scientific evidence and align with their European counterparts by ceasing the promotion of social affirmation, puberty blockers, cross-sex hormones, and surgeries for children and adolescents experiencing distress over their biological sex. Instead, it advocates for comprehensive evaluations and therapies focused on identifying and addressing underlying psychological co-morbidities.

Rates of transgenderism in children have seen a rapid increase in recent years in the U.S., prompting discussions among parents, schools, policymakers, and medical professionals on how to approach and address the issue. At one end of the spectrum, activist groups and a vocal segment of the medical establishment advocate for what is termed "gender-affirming care." This approach involves encouraging children with transgender inclinations to undergo potentially irreversible surgical and hormonal interventions, the long-term consequences of which remain uncertain. These interventions can range from halting normal pubertal development to surgical procedures removing healthy breast tissue and genitalia.

Recognising the potential for significant harm, especially with over 300,000 youths aged 13–17 in the U.S. now identifying as transgender, some states are implementing policies aimed at safeguarding children from such irreversible treatments. These measures are particularly crucial during a critical period in their physical, mental, and emotional development.

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