US medical group backs youth gender-related treatments, but commissions research review

NEW YORK - The American Academy of Paediatrics (AAP) backed gender-related treatments for children on Thursday, reaffirming its position from 2018 on a medical approach that has since been banned in 19 states.

But the influential group of doctors also took an extra step of commissioning a systematic review of medical research on the treatments, following similar efforts in Europe that found uncertain evidence for their effectiveness in adolescents.

Critics across the political spectrum – including a small but vocal group of pediatricians – have been calling for a closer look at the evidence in recent years, particularly as the number of adolescents who identify as transgender has rapidly increased.

The treatments are relatively new, and few studies have tracked their long-term effects.

Health bodies in England and Sweden have limited access to the treatments after carrying out systematic reviews, the gold standard for evaluating medical research.

“The board has confidence that the existing evidence is such that the current policy is appropriate,” said Mr Mark Del Monte, the chief executive of the AAP. “At the same time, the board recognised that additional detail would be helpful here.”

As for the policy changes in Europe, he said: “They engaged in their process, we’re engaging in our process.”

After completing the review, he said, the group will issue additional clinical guidance for doctors and likely update its recommendations.

All 16 board members of the AAP, which represents 67,000 paediatricians across the United States, voted to reaffirm the 2018 guidelines at a meeting Thursday in Itasca, Illinois.

The vote comes at a time of intense political pressures on transgender people and the doctors who care for them.

Over the past two years, Republican lawmakers across the country have banned what is known as gender-affirming care, which can include psychotherapy, puberty-blocking drugs, hormones and, rarely, surgeries.

Opponents of the care argue that it is experimental and children lack the maturity to consent to it.

The AAP has roundly condemned the legislative bans as a dangerous intrusion into complex medical decisions between doctors and families, and has filed amicus briefs to support the many legal challenges brought against the bans by civil rights groups.

Position statements like those voted on today remain valid for five years before they are up for review, at which point they may be reaffirmed, retired or revised in the light of new evidence. NYTIMES