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medicine and transgender people

The American Medical Association (AMA) is a national professional organization of over 270,000 medical professionals.

Founded in 1847, their goals are scientific advancement, standards for medical education, launching a program of medical ethics, and improved public health.

Trans and gender diverse people

AMA has published several positions and policies supporting transgender and gender diverse populations.

H-65.964

  • Access to Basic Human Services for Transgender Individuals H-65.964
  • Our AMA: (1) opposes policies preventing transgender individuals from accessing basic human services and public facilities in line with one’s gender identity, including, but not limited to, the use of restrooms; and (2) will advocate for the creation of policies that promote social equality and safe access to basic human services and public facilities for transgender individuals according to one’s gender identity.

H-185.950

  • Removing Financial Barriers to Care for Transgender Patients
  • Our AMA supports public and private health insurance coverage for treatment of gender dysphoria as recommended by the patient’s physician. (2016)

H-460.893

  • Patient-Reported Outcomes in Gender Confirmation Surgery
  • Our AMA supports: (1) initiatives and research developed by specialty societies and other relevant stakeholders to establish standardized protocols for patient selection, surgical management, and preoperative and postoperative care for transgender patients undergoing gender confirmation surgeries; and (2) implementation of standardized tools, such as questionnaires, developed by specialty societies and other relevant stakeholders to evaluate outcomes of gender confirmation surgeries. (2018)

H-65.956

  • Right for Gamete Preservation Therapies
  • 1. Fertility preservation services are recognized by our AMA as an option for the members of the transgender and non-binary community who wish to preserve future fertility through gamete preservation prior to undergoing gender affirming medical or surgical therapies.2. Our AMA supports the right of transgender or non-binary individuals to seek gamete preservation therapies.

H-430.982

  • Appropriate Placement of Transgender Prisoners
  • 1. Our AMA supports the ability of transgender prisoners to be placed in facilities, if they so choose, that are reflective of their affirmed gender status, regardless of the prisoner’s genitalia, chromosomal make-up, hormonal treatment, or non-, pre-, or post-operative status.
  • 2. Our AMA supports that the facilities housing transgender prisoners shall not be a form of administrative segregation or solitary confinement. (2018)

H-40.966

  • Military Medical Policies Affecting Transgender Individuals
  • Our American Medical Association affirms that there is no medically valid reason to exclude transgender individuals from service in the US military and affirms transgender service members be provided care as determined by patient and physician according to the same medical standards that apply to non-transgender personnel.

H-60.927

  • Reducing Suicide Risk Among Lesbian, Gay, Bisexual, Transgender, and Questioning Youth Through Collaboration with Allied Organizations
  • Our AMA will partner with public and private organizations dedicated to public health and public policy to reduce lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth suicide and improve health among LGBTQ youth. (2012)

H-460.907

  • Encouraging Research Into the Impact of Long-Term Administration of Hormone Replacement Therapy in Transgender Patients
  • Our AMA encourages research into the impact of long-term administration of hormone replacement therapy in transgender patients.

H-65.957

  • Preventing Anti-Transgender Violence
  • Our AMA will: (1) partner with other medical organizations and stakeholders to immediately increase efforts to educate the general public, legislators, and members of law enforcement using verified data related to the hate crimes against transgender individuals highlighting the disproportionate number of Black transgender women who have succumbed to violent deaths: (2) advocate for federal, state, and local law enforcement agencies to consistently collect and report data on hate crimes, including victim demographics, to the FBI; for the federal government to provide incentives for such reporting; and for demographic data on an individual’s birth sex and gender identity be incorporated into the National Crime Victimization Survey and the National Violent Death Reporting System, in order to quickly identify positive and negative trends so resources may be appropriately disseminated; (3) advocate for a central law enforcement database to collect data about reported hate crimes that correctly identifies an individual’s birth sex and gender identity, in order to quickly identify positive and negative trends so resources may be appropriately disseminated; (4) advocate for stronger law enforcement policies regarding interactions with transgender individuals to prevent bias and mistreatment and increase community trust; and (5) advocate for local, state, and federal efforts that will increase access to mental health treatment and that will develop models designed to address the health disparities that LGBTQ individuals experience.

D-460.966

  • Endorsing the Creation of a Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Research IRB Training
  • Our AMA will work with appropriate stakeholders to support the creation of model training for Institutional Review Boards to use and/or modify for their unique institutional needs as it relates to research collecting data on Lesbian, Gay, Bi-sexual, Transgender and Queer populations.

H-60.927

  • Reducing Suicide Risk Among Lesbian, Gay, Bisexual, Transgender, and Questioning Youth Through Collaboration with Allied Organizations
  • Our AMA will partner with public and private organizations dedicated to public health and public policy to reduce lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth suicide and improve health among LGBTQ youth.

H-160.991

  • Health Care Needs of Lesbian, Gay, Bisexual, Transgender and Queer Populations
  • 1. Our AMA: (a) believes that the physician’s nonjudgmental recognition of patients’ sexual orientations, sexual behaviors, and gender identities enhances the ability to render optimal patient care in health as well as in illness. In the case of lesbian, gay, bisexual, transgender, queer/questioning, and other (LGBTQ) patients, this recognition is especially important to address the specific health care needs of people who are or may be LGBTQ; (b) is committed to taking a leadership role in: (i) educating physicians on the current state of research in and knowledge of LGBTQ Health and the need to elicit relevant gender and sexuality information from our patients; these efforts should start in medical school, but must also be a part of continuing medical education; (ii) educating physicians to recognize the physical and psychological needs of LGBTQ patients; (iii) encouraging the development of educational programs in LGBTQ Health; (iv) encouraging physicians to seek out local or national experts in the health care needs of LGBTQ people so that all physicians will achieve a better understanding of the medical needs of these populations; and (v) working with LGBTQ communities to offer physicians the opportunity to better understand the medical needs of LGBTQ patients; and (c) opposes, the use of “reparative” or “conversion” therapy for sexual orientation or gender identity.
  • 2. Our AMA will collaborate with our partner organizations to educate physicians regarding: (i) the need for sexual and gender minority individuals to undergo regular cancer and sexually transmitted infection screenings based on anatomy due to their comparable or elevated risk for these conditions; and (ii) the need for comprehensive screening for sexually transmitted diseases in men who have sex with men; (iii) appropriate safe sex techniques to avoid the risk for sexually transmitted diseases; and (iv) that individuals who identify as a sexual and/or gender minority (lesbian, gay, bisexual, transgender, queer/questioning individuals) experience intimate partner violence, and how sexual and gender minorities present with intimate partner violence differs from their cisgender, heterosexual peers and may have unique complicating factors.
  • 3. Our AMA will continue to work alongside our partner organizations, including GLMA, to increase physician competency on LGBTQ health issues.
  • 4. Our AMA will continue to explore opportunities to collaborate with other organizations, focusing on issues of mutual concern in order to provide the most comprehensive and up-to-date education and information to enable the provision of high quality and culturally competent care to LGBTQ people.

H-460.893

  • Patient-Reported Outcomes in Gender Confirmation Surgery
  • Our AMA supports: (1) initiatives and research developed by specialty societies and other relevant stakeholders to establish standardized protocols for patient selection, surgical management, and preoperative and postoperative care for transgender patients undergoing gender confirmation surgeries; and (2) implementation of standardized tools, such as questionnaires, developed by specialty societies and other relevant stakeholders to evaluate outcomes of gender confirmation surgeries.

References

AMA Advocating for the LGBTQ community. https://www.ama-assn.org/delivering-care/population-care/advocating-lgbtq-community

AMA/GLMA (September 2018). Transgender individuals’ access to public facilities. 18-281734:9/17 https://www.ama-assn.org/system/files/2019-03/transgender-public-facilities-issue-brief.pdf

AMA/GLMA (February 2019). Health insurance coverage for gender- affirming care of transgender patients. 19-321820:2/19 https://www.ama-assn.org/system/files/2019-03/transgender-coverage-issue-brief.pdf

AMA/GLMA (April 2022). Sexual orientation and gender identity change efforts (so-called “conversion therapy”). 22-676341:04/22 https://www.ama-assn.org/system/files/conversion-therapy-issue-brief.pdf

AMA (June 12, 2020). AMA opposes effort to allow discrimination against patients. https://www.ama-assn.org/press-center/press-releases/ama-opposes-effort-allow-discrimination-against-patients

Resources

American Medical Association (ama-assn.org)

Allied health professions are health care professions that provide a range of diagnostic, technical, therapeutic, and support services in connection with health care. 

References

Jecke, L., Zepf, F.D. Delivering transgender-specific knowledge and skills into health and allied health studies and training: a systematic review. Eur Child Adolesc Psychiatry (2023). https://doi.org/10.1007/s00787-023-02195-8

Exploring Interactions Between Transgender, Gender-Diverse, and Nonbinary Individuals and Allied Health Professionals in Clinical Practice: A Scoping Review https://doi.org/10.1089/trgh.2022.0222

Admiral Rachel L. Levine, MD is an American pediatrician and government health official. Levine is the first out transgender four-star officer in the US uniformed services. Levine was appointed as Assistant Secretary for Health by the US Senate in 2021.

Background

Levine was born October 28, 1957 and grew up in Wakefield, Massachusetts. Both of Levine’s parents were lawyers. Levine has an older sibling.

After private school, Levine graduated from Harvard College, then Tulane University School of Medicine. Levine did a pediatrics residency and adolescent medicine postdoc at Mount Sinai Medical Center in New York, then took a position at Penn State College of Medicine as well as Penn State Hershey Medical Center.

Levine married Martha Peaslee Levine in 1988. They have two children. Levine transitioned in 2011, and they divorced in 2013.

Levine was appointed Pennsylvania Physician General in 2015 and Secretary of Health in 2017. In 2020 Levine was responsible for the commonwealth’s COVID response. In 2021, the Senate confirmed Levine as Assistant Secretary for Health following President Joe Biden’s nomination.

Among Levine’s first initiatives were addressing bullying, suicide, discriminatory policies, and isolation during the COVID-19 pandemic as pressing issues among LGBTQ youth. Levine has criticized Florida’s “Don’t Say Gay” bill and the push in some conservative states to investigate parents who provide gender-affirming care to their children.

Levine became a lightning rod for anti-transgender hatred from anti-trans lawmakers and media figures after taking office.

Support of gender affirming care for youth

Levine supports the position of the American Academy of Pediatrics regarding trans and gender diverse youth. The AAP states that the gender affirming model of care is the current medical consensus.

Levine discussed this in a 2023 keynote at Yale University:

Levine described gender-affirming care — which includes puberty blockers, gender-affirming hormones and surgical procedures, among other interventions —  as “safe,” “effective” and “medically necessary.” 

Levine described how transgender and nonbinary youth are disproportionately burdened by mental health challenges. She noted that gender-affirming interventions are associated with lower odds of depressive symptoms, self-harm and suicidal thoughts. Given this, Levine said, gender-affirming care has been life-saving for thousands of young LGBTQI+ people across the country.

Zhang (2023)

References

Zhang, William ( FEB 07, 2023). Assistant Secretary for Health Rachel L. Levine discusses LGBTQI+ health at Yale Law School. Yale Daily News https://yaledailynews.com/blog/2023/02/07/assistant-secretary-for-health-rachel-l-levine-discusses-lgbtqi-health-at-yale-law-school/

Zezima, Katie (June 1, 2016). Meet Rachel Levine, one of the very few transgender public officials in America. The Washington Post [archive] https://www.washingtonpost.com/politics/meet-rachel-levine-one-of-the-very-few-transgender-public-officials-in-america/2016/06/01/cf6e2332-2415-11e6-8690-f14ca9de2972_story.html

Sullivan, Eileen (January 19, 2021). Biden’s pick for Health and Human Services role would be first transgender federal official confirmed by the Senate. The New York Times https://www.nytimes.com/2021/01/19/us/politics/rachel-levine-transgender-health-human-services.html

Weissert, Will (January 19, 2021). Biden picks transgender woman as assistant health secretary. AP News https://apnews.com/article/joe-biden-pandemics-biden-cabinet-health-coronavirus-pandemic-4eee53439e9c2b4c27fcf4e7f572cb0e

Diamond, Dan (October 19, 2021). Rachel Levine, openly transgender health official, to be sworn in as four-star admiral in Public Health Service. Washington Post https://www.washingtonpost.com/health/2021/10/19/levine-transgender-four-star-admiral-public-health-service/

Hackney, Suzette (March 13, 2022). ‘Be true to yourself’: A message from the nation’s highest-ranking openly transgender official. USA Today https://www.usatoday.com/in-depth/opinion/2022/03/13/rachel-levine-honoree-usa-today-women-of-the-year/6600134001/

Goodin-Smith, Oona (January 19, 2021). What to know about Rachel Levine, the history-making Pa. health official tapped for Biden administration. The Philadelphia Inquirer https://www.inquirer.com/news/rachel-levine-joe-biden-assistant-health-secretary-hhs-transgender-pennsylvania-20210119.html

Loveland, Barry (February 6, 2017). LGBT Oral History: Rachel Levine. (PDF). LGBT Center of Central PA History Project Dickinson College Archives & Special Collections. Carlisle, PA, USA. [archive] http://archives.dickinson.edu/sites/all/files/files_lgbt/LGBT-interview-transcription-Levine-Rachel-064.pdf

Resources

US Dept. of Health and Human Services (hhs.gov)

Wikipedia (en.wikipedia.org)

Twitter (twitter.com)

Michelle Forcier is an American pediatrician who specializes in sexual health and gender identity for adolescents.

Background

Michelle Marie Forcier earned a bachelor’s degree from Brown University in 1987, followed by a medical degree from University of Connecticut School of Medicine in 1992. In 1997 Forcier earned a master’s degree from University of North Carolina at Chapel Hill School of Public Health. Forcier did a pediatric residency at University of Utah, followed by fellowships at University of North Carolina at Chapel Hill School of Medicine, Planned Parenthood Central North Carolina, and Department of Family Medicine, University of Rochester School of Medicine.

Forcier is or has been licensed in Massachusetts, Rhode Island, North Carolina, Illinois, South Carolina, Alabama, and Utah. Forcier has taught at Duke University, University of North Carolina, and Northwestern University. Since 2009 Forcier has taught at Brown University.

Forcier is a member of the American Medical Association and the American Academy of Pediatrics.

Forcier married pediatrician Geoffrey Abbott “Geoff” Allen (born 1961). They have one child.

Forcier is known to many from an appearance in the 2022 anti-trans propaganda piece What Is a Woman? In it, Forcier earnestly explains why affirming models of care for minors are the American medical consensus. Many people who enjoy anti-trans extremist Matt Walsh’s bad-faith interview tactics found the exchange entertaining.

Forcier was named in lawsuits filed by ex-trans activists Layton Ulery and Isabelle Ayala.

References

Norton, Amy (January 19, 2023). Hormonal Therapies Are Boosting the Mental Health of Trans Youth. U.S. News & World Report https://www.usnews.com/news/health-news/articles/2023-01-19/hormonal-therapies-are-boosting-the-mental-health-of-trans-youth

Crandall, Brian (June 7, 2016). RI doctor leads effort on caring for transgender children. WJAR https://turnto10.com/news/local/ri-doctor-leads-effort-on-caring-for-transgender-children

Petrow, Steven (March 7, 2017). Civilities: Taking all your questions about transgender teens with Brown U. expert Dr. Michelle Forcier and Steven Petrow. Washington Post https://live.washingtonpost.com/civilities-with-steven-petrow-20170307.html

Knox, Liam (September 25, 2022). Attack on Vanderbilt Clinic Has Ripple Effects. Inside Higher Ed https://www.insidehighered.com/news/2022/09/26/trans-health-clinic-weathers-political-firestorm

Samuel E, Forcier M (2015). Acute medical care for the transgender patient. In Sex and Gender in Acute Care Medicine, Ed: McGregor AJ, Choo EK, Becker BM. NY Cambridge University Press, 2015: 216-229, ISBN 9781107668164

Lecture, Pediatric and Adolescent Gender Care, Web Seminar, Fenway Health Center, 2015. Taped lecture, pending pub on line at http://fenwayhealth.org/the-fenwayinstitute/education/transgender-health-conference/

Transgender is a Pediatric Opportunity: Pediatric Endocrine Nursing Society, Orlando FL 2012.

Services for Transgender Youth in Primary Care Settings. Society for Teachers in Family Medicine, US 2014.

Puberty Blockers for Use in Transgender Children, Medical Advisory Meeting, Chicago 2014.

Transgender Health Panel, Gender Spectrum East, Baltimore 2014

Rupp, William (August 20, 2011). ‘This Old House’ Picks ‘Happy Renters.’ Patch https://patch.com/rhode-island/barrington/this-old-house-picks-happy-renters

Media

Brown University (November 27, 2023) Trans Youth Now Series: Michelle Forcier. https://www.youtube.com/watch?v=onR2ctah3UE

NBC Nightly News (April 21, 2015). One Doctor Explains the Journey for Kids Who Are Transitioning. https://www.nbcnews.com/nightly-news/video/one-doctor-explains-the-journey-for-kids-who-are-transitioning-431478851632

Healio (October 18, 2019). AAP supports ‘gender-affirming care’ for youth. https://www.youtube.com/watch?v=f4qlSOdu6MI

Note: this profile previously misstated Forcier’s name at birth and spouse. This site regrets the errors.

Resources

Brown University (brown.edu)

LinkedIn (linkedin.com)

Instagram (instagram.com)

Lifespan (lifespan.org) [archive]

Catherine Williamson is a British occupational therapist who is active in the “gender critical” movement.

Williamson is involved with anti-trans organization Society for Evidence-based Gender Medicine (SEGM).

Background

Williamson worked as Multi-Disciplinary Team Leader/Senior Practitioner at the Sheffield Gender Identity Clinic, an adult service in the UK. Williamson resigned in 2019 amid “clinical concerns” about the rapidly-changing demographics and increasing complexity of the patient population, and over the assessment process in NHS gender services.

Williams’ resignation stated in part:

Over the last eighteen months, I have repeatedly discussed my clinical concerns about the inadequacy of the assessment pathways at the clinic. I have also regularly highlighted the increasing vulnerability and complexity of people referred to the clinic. That is, that although a minority of people have gender identity concerns, for a majority, medical transition is the solution to difficulties separate from gender. This is supported by audits I have undertaken. These patients may meet the diagnostic criteria for gender dysphoria and transsexualism, but their primary difficulties are not about gender. These include autism, past trauma, significant childhood and adolescent bullying, personality disorder, mental illness, body dysmorphia and eating disorders. The clinic is wedded to a medically-focused pathway which does not adequately explore this context. The service fails to fully consider the psychological and social factors which might influence a person’s decision to transition. Wider political pressures and the demands of a lengthy waiting list have led to a focus on streamlining the service which has eclipsed clinical robustness. Similar concerns have been raised by clinicians working in gender services in other NHS Trusts.

References

Williamson C (2019). Resignation Letter to Senior Operational Manager Covering Sheffield Gender. Identity Service, Sheffield Health and Social Care NHS. cited in https://doi.org/10.1177/263440412110107

Avi Ring was a Scandinavian physiologist and anti-transgender activist.

Ring founded Gender Identity Challenge (GENID) and was involved with anti-trans organizations Genspect and Society for Evidence-based Gender Medicine (SEGM). Ring was a major proponent of the disputed disease “rapid-onset gender dysphoria.”

Background

Ring earned a PhD in Physiology and Biophysics from the University of Uppsala, Sweden. Ring then taught there as an associate professor and worked in cellular electrophysiology. At the Norwegian Defence Research Establishment (FFI), Ring was a chief scientist, working on countermeasures to chemical warfare.

Ring and spouse Eva lived in the Lofthus borough of Oslo and had a transgender child named Jennifer (1985–2017). The family had a complicated relationship with Jennifer.

Anti-transgender activism

Ring’s child Jennifer transitioned at age 28. Jennifer dealt with a number of problems in living beyond trans issues, and committed suicide four years after transition, in 2017.

At the same time, Filter magazine profiled the case of Jennifer Ring, a 32-year-old trans woman who hanged herself four years after her surgery. An expert on psychosis who was shown her medical journal by her father, Avi Ring, was quoted as saying that she had shown clear signs of psychosis at the time she first sought treatment for gender dysphoria.

Indeed, the first clinic she approached refused to treat her, citing signs of schizotypal symptoms and lack of a history of gender dysphoria. But the team at Karolinska went ahead. “Karolinska don’t stop anyone; virtually 100% get sex reassignment,” says Ring.

Orange (2020)

Ring founded GENID: Gender Identity Challenge and began connecting with other parents skeptical of trans healthcare:

Gender Identity Challenge Scandinavia (GICS) are behind the push to change the public debate. Set up by retired neurophysiologist Ring, toxicologist Karin Svens and Norwegian teacher Marit Rønstad, they label themselves as a group of concerned parents. Other actors are psychiatrist Christopher Gillberg whose article in newspaper Svenska Dagbladet decried hormone treatment and surgery for young people. An investigative TV programme also attacked a hospital providing gender-affirming care. The campaign against securing access to gender-affirming healthcare for trans people along with media transphobia led to the Swedish government halting plans to change the age for young people to access gender-affirming care. In February 2022, the National Board of Health and Welfare issued new guidelines preventing young trans people accessing puberty blockers, arguing incorrectly that ‘costs outweigh the benefits’ and in disagreement with guidance from the World Professional Association of Transgender Health. This was in response to seeing a rise in people assigned female at birth accessing services.

Anti-trans actors tend to verge on social media, particularly since the start of the COVID-19 pandemic. They place themselves outside the pro-feminist and pro-LGBTI+ rights discourse in Sweden, which they see as undermining the state’s ability to protect people during the pandemic.

It is argued that this approach is not yet having the same impact as ‘gender critical’ groups in the UK or Spain because feminism is a less politically charged idea in Sweden than other European countries. Barring one, all political parties include feminism in their policies. However, this appears to be shifting and concerningly, the HOPE not Hate Charitable Trust found the Swedish general public expressed more anti-feminist sentiment than Poland (30%), the UK (28%), France (26%), Hungary (22%), Germany (19%) and the Netherlands (15%).

Rowlands (2023)

Ring served on a panel with the Norwegian Directory of Health during development of new trans treatment guidelines and lectured at both the Norwegian and Swedish Parliament seminars.

In 2020 Ring and William Malone published a letter criticizing a 2019 study by Richard Bränström and John E. Pachankis. In the first total population study of transgender people, Bränström and Pachankis found that for the 2,679 trans people on Sweden’s national patient register diagnosed with gender incongruence, “the longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.”

On September 25, 2023, anti-trans group Genspect announced Ring’s death. This was confirmed in a posthumous piece Ring wrote for Subjekt. Ring asked relatives to publish a piece arguing against banning conversion therapy in Norway under paragraph 270.

References

Madelene Pollnow, Mattias Göransson, Oskar Sonn Lindell (November, 18 2019). [Speed-blind] Fartblinda. Filter https://magasinetfilter.se/granskning/fartblinda/

Orange, Richard (February 22, 2020). Teenage transgender row splits Sweden as dysphoria diagnoses soar by 1,500%. The Guardian https://www.theguardian.com/society/2020/feb/22/ssweden-teenage-transgender-row-dysphoria-diagnoses-soar

Bränström R, Pachankis JE: Reduction in mental health treatment utilization among transgender individuals after gender-affirming surgeries: a total population study. Am J Psychiatry 2020; 177:727–734 https://doi.org/10.1176/appi.ajp.2020.19111169

Ring A, Malone WJ (2020). Letter: Confounding Effects on Mental Health Observations After Sex Reassignment Surgery. Am J Psychiatry 177:8, August 2020 https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.19111169

Ring, Avi (October 14, 2023) [The Storting should not approve the ban on conversion therapy.] Stortinget bør ikke godkjenne forbudet mot konverteringsterapi. Subjekt https://subjekt.no/2023/10/14/stortinget-bor-ikke-godkjenne-forbudet-mot-konverteringsterapi/

Rowlands, Sebastian (2023) Landscape analysis: What we know on anti-gender movement measures and actors targeting trans people across Europe and Central Asia. TGEU https://tgeu.org/wp-content/uploads/2023/03/tgeu-agm-landscape-analysis-2023.pdf

Resources

Trans Data Library (transdatalibrary.org)

Twitter (twitter.com)

GENID Gender Identity Challenge Skandinavia (genderchallenge.no)

GENID Gender Identity Challenge Sweden (genid.se)

Jacob Edward “Ed” Les is a Canadian pediatrician who has written inflammatory materials about trans and gender diverse people.

Les is involved with anti-trans organization Society for Evidence-Based Gender Medicine (SEGM).

Les maintained a blog called Ruminations on a personal site, later moved to Substack.

In 2023, Les began hosting a podcast called Cloudy with a Risk of Children.

References

Siobhan (January 30, 2019). Calgary Physician Calls Transgender People “Demented, Distorted.” Freethought Blogs https://freethoughtblogs.com/atg/2019/01/30/calgary-physician-calls-transgender-people-demented-distorted/ [archive]

“Dr Sarah” (February 1, 2019). The Transphobic Comments Of Dr Jacob Edward Les. Geeky Humanist / Freethought Blogs https://freethoughtblogs.com/geekyhumanist/2019/02/01/the-transphobic-comments-of-dr-jacob-edward-les/ [archive]

Resources

Ed Les (dredles.com) [site active 2018–2021: archive]

Twitter (/twitter.com)

Substack (substack.com)

The American College of Pediatricians (ACPeds) is a socially conservative organization of activist pediatricians. They are designated as an anti-LGBTQ hate group by the Southern Poverty Law Center.

Members have consistently taken a stand against gender affirming models of care for trans and gender diverse youth. With only about 700 members, ACPeds are a conservative fringe group within pediatrics, only about 1% of the size of mainstream organization American Academy of Pediatrics. With about 67,000 members, the American Academy of Pediatrics remains supportive of gender affirming care for youth.

ACPeds is listed as a hate group by the Southern Poverty Law Center:

The American College of Pediatricians (ACPeds) is a fringe anti-LGBTQ hate group that masquerades as the premier U.S. association of pediatricians to push anti-LGBTQ junk science, primarily via far-right conservative media and filing amicus briefs in cases related to gay adoption and marriage equality.​

SPLC (2023)

LGBTQ+ media advocacy organization GLAAD notes that the group:

  • opposes same-sex marriage
  • opposes same-sex adoption
  • opposes abortion
  • opposes gender-affirming care for youth
  • opposes LGBTQ youth access to sports
  • opposes drag queen story hours
  • supports non-affirming models of care for gender diverse youth, including conversion therapy
  • claims “transgenderism is a belief system that increasingly looks like a cultish religion”
  • claims LGBTQ activists “have pedophilia intrinsically woven into their agenda”

In 2023 ACPeds launched an anti-trans website called Biological Integrity. The site has misleading information about trans healthcare.

Key people

Board

  • Michael Artigues
  • Jane Anderson
  • Tom Benton
  • Christina Chan
  • Scott S. Field
  • Salwa Gendi
  • Russell Gombosi
  • Mark Grubb
  • Patricia Lee June
  • J. Wells Logan
  • Renata Moon
  • David Olson
  • L. David Perry
  • Robin Pierucci
  • Richard Sandler
  • Jill Simons
  • Ron Smith .
  • William Stigall
  • Den A. Trumbull
  • Kimberly A. Vacca
  • Leah Willson
  • Nick Yates

2018 letter to Trump Administration

In 2018, a consortium of anti-transgender activists associated with ACPeds petitioned the Trump Administration with the goal of “upholding the scientific definition of sex in law and policy,” adding “an individual who identifies as transgender remains either a biological male or female.”

Signatories

  • Michelle Cretella, M.D. Executive Director, American College of Pediatricians
  • Donna Harrison, M.D. Executive Director, American Association of Pro-life Obstetricians and Gynecologists
  • David Stevens, M.D. CEO, Christian Medical and Dental Associations
  • Peter Morrow, M.D. President, Catholic Medical Association
  • Stephen M. Krason, Ph.D. President, Society of Catholic Social Scientists
  • Paul McHugh, M.D. University Distinguished Service Professor of Psychiatry at Johns Hopkins Medical School and the former psychiatrist in chief at Johns Hopkins Hospital
  • Michael K. Laidlaw, M.D. Endocrinologist and member of gdworkinggroup.org
  • Craig Stump M.D., Ph.D., FACE Endocrinologist, University of Arizona College of Medicine
  • Paul W. Hruz M.D., Ph.D. Pediatric Endocrinologist, Physician-Scientist, Associate Professor of Pediatrics, Associate Professor of Cellular Biology & Physiology
  • Angela Lanfranchi M.D. FACS Clinical Assistant Professor of Surgery Rutgers-Robert Wood Johnson Medical School
  • Susan J. Bradley, M.D., FRCP(C) Professor Emerita, University of Toronto
  • J. Michael Bailey, Ph.D. Professor of Psychology Northwestern University
  • Marie T. Hilliard, MS, MA, JCL, Ph.D., RN The National Catholic Bioethics Center Mary Lou Singleton, MSN, FPC-BC
  • Christopher Doyle, LPC Co-Founder National Task Force for Therapy Equality
  • David Pickup, LMFT Co-Founder National Task Force for Therapy Equality
  • Laura Haynes, Ph.D., California Licensed Psychologist USA Representative, International Federation for Therapeutic and Counseling Choice (IFTCC.org)
  • Michael Farris, J.D. President, CEO, & General Counsel Alliance Defending Freedom
  • Matthew D. Staver, Esq. Founder and President, Liberty Council
  • Charles LiMandri, J.D. Founder and President, Freedom of Conscience Defense Fund
  • Robert J. Muise, Esq. Co-Founder, American Freedom Law Center
  • Gerard V. Bradley, J.D. Professor of Law University of Notre Dame
  • Steven D. Smith, J.D. Warren Distinguished Professor of Law University of San Diego
  • Maimon Schwarzschild, J.D. Professor of Law University of San Diego
  • Larry Alexander, LL.B. Warren Distinguished Professor of Law University of San Diego
  • Tony Perkins President Family Research Council
  • Frank Cannon President American Principles Project
  • Matthew J. Franck, Ph.D. Senior Fellow, Witherspoon Institute
  • Sharon Slater President, Family Watch International Austin Ruse President, Center for Family and Human Rights
  • Allan C. Carlson, Ph.D., Editor, The Natural Family: An International Journal of Research and Policy
  • Patrick Lee, Ph.D. McAleer Professor of Bioethics Center for Bioethics, Franciscan University of Steubenville
  • Christopher Wolfe, Ph.D. Distinguished Affiliate Professor, University of Dallas President, American Public Philosophy Institute
  • Rev. D. Paul Sullins, Ph.D. Research Professor of Sociology and Director, Leo Institute for Catholic Social Research, The Catholic University of America
  • Robert G Kennedy, Ph.D. Department of Catholic Studies University of St. Thomas
  • Jennifer Roback Morse, Ph.D. Founder and President, The Ruth Institute

Cited works by

2023 data leak

ACPeds inadvertently shared links to an unsecured Google Drive that contained 10,000 files, including membership information, financial data, and strategy. As of spring 2022, the College counted slightly more than 700 active members. An internal database listed 1,200 past and current members. Via WIRED:

Many of the College’s most radical views target transgender people, and in particular, transgender youth. The leak, which had been indexed by Google, includes volumes of literature crafted specifically to influence relationships between practicing pediatricians, parents, and their children. It includes reams of marketing material the College aims to distribute widely among public school officials.

Doctors Protecting Children

In 2024, ACPeds published an anti-trans petition under the name Doctors Protecting Children.

  • Alliance for Hippocratic Medicine (AHM)
  • American Academy of Medical Ethics
  • American Association of Christian Counselors (AACC)
  • American College of Family Medicine (ACFM)
  • American College of Pediatricians (ACPeds)
  • Association of American Physicians and Surgeons (AAPS)
  • Catholic Health Care Leadership Alliance (CHCLA)
  • Catholic Medical Association (CMA)
  • Christian Medical & Dental Associations (CMDA)
  • Coalition of Jewish Values
  • Colorado Principled Physicians
  • Genspect
  • Honey Lake Clinic
  • International Foundation for Therapeutic and Counselling Choice (IFTCC)
  • National Association of Catholic Nurses, USA
  • National Catholic Bioethics Center (NCBC)
  • North Carolina Physicians for Freedom (NCPFF)
  • South Carolina Physicians for Freedom (SCPFF)

References

Cameron, Dell; Mehrotra, Dhruv (May 2, 2023). An Anti-Trans Doctor Group Leaked 10,000 Confidential Files. WIRED https://www.wired.com/story/american-college-pediatricians-google-drive-leak/

Stahl, Aviva (April 16, 2021). Meet The “Fringe Extremists” Pushing Flawed Science To Target Trans Kids Buzzfeed News https://www.buzzfeednews.com/article/avivastahl/transgender-trans-kids-healthcare-science

Cretella M et al. (December 4, 2018). [Letter to Matthew Whitaker, Alex Azar, and Betsy DeVos.] https://acpeds.org/assets/imported/12.4.18-Final_Revised_-12.4.18-Joint-letter-to-HHS-DOJ-DOE-Uphold-Definition-of-Sex.pdf

Cretella, Michelle (2018). Gender Dysphoria in Children. ACPeds https://acpeds.org/position-statements/gender-dysphoria-in-children

Resources

Trans Data Library (transdatalibrary.org)

SPLC (splcenter.org)

GLAAD (glaad.org)

Wikipedia (en.wikipedia.org)

American College of Pediatricians (acpeds.org)

Doctors Protecting Children (doctorsprotectingchildren.org)

Biological Integrity Initiative (biologicalintegrity.org)

Twitter (twitter.com)

YouTube (youtube.com)

Patrick K. Hunter is an American pediatrician and anti-transgender activist.

Hunter is affiliated with anti-trans hate group Society for Evidence-based Gender Medicine (SEGM).

Background

Patrick Kyran Hunter was born in May 1966. Hunter served in the US Army. Hunter earned a bachelor’s degree from Miami University, a master’s degree from the University of Mary, and a medical degree from University of Louisville School of Medicine.

Hunter has served as a general pediatrician with Pensacola Pediatrics and a Clinical Professor at Florida State University’s College of Medicine.

Anti-transgender activism

2022 HHS meeting

On April 25, 2022 Society for Evidence-Based Gender Medicine arranged a meeting with US government officials on healthcare for trans and gender diverse youth. Hunter was listed as an attendee.

AAP Resolution 27 (2022)

In 2022, Hunter was a signatory on American Academy of Pediatrics Resolution 27, that year’s attempt to protest consensus on care for gender diverse youth. Hunter and four other pediatricians drafted Resolution 27 critical of AAP’s consensus on best practices for gender diverse youth. The authors are:

  • Julia W. Mason (Gresham, Oregon)
  • Sarah B. Palmer (Carmel, Indiana)
  • Paula Brinkley (Berkeley, California – Stanford Children’s)
  • Debra Hendrickson (Reno, Nevada – Northern Nevada Pediatrics)
  • Patrick K. Hunter (Milton, Florida – Pensacola Pediatrics)

In 2022, Florida Governor Ron DeSantis appointed Hunter, Amy Derick, David Diamond, and Nicole Justice to the Florida Board of Medicine.

Hunter’s anti-trans writings have appeared on the Our Duty website, among others.

References

Staff report (June 17, 2022). Governor Ron DeSantis Appoints Four to the Board of Medicine. https://www.flgov.com/2022/06/17/governor-ron-desantis-appoints-four-to-the-board-of-medicine/

Hunter PK (2022). Political Issues Surrounding Gender-Affirming Care for Transgender Youth. JAMA Pediatr. 2022 Mar 1;176(3):322-323. https://doi.org/10.1001/jamapediatrics.2021.5348

Jones, Zinnia (Jul 21, 2022). IDENTIFIED: The 5 redacted-signature pediatricians who signed the Genspect-promoted Resolution #27 to the American Academy of Pediatrics Julia W. Mason (SEGM) Sarah B. Palmer Paula Brinkley (Stanford Children’s Health) Debra Hendrickson Patrick Hunter (Florida Board of Medicine) https://x.com/ZJemptv/status/1550042000246067201

US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) (April 25, 2022). EO 12866 Meeting 0945-AA17. Nondiscrimination in Health Programs and Activities https://mobile.reginfo.gov/public/do/viewEO12866Meeting?viewRule=true&rin=0945-AA17&meetingId=131923&acronym=0945-HHS/OCR

Media

Our Duty (November 10, 2022). Patrick K Hunter on treatments for gender dysphoria in minors. https://www.youtube.com/watch?v=AS5GNP9ocHo

Resources

NPI DB (npidb.org)

  • Patrick K. Hunter NPI #1952384810
  • https://npidb.org/doctors/allopathic_osteopathic_physicians/pediatrics_208000000x/1952384810.aspx

Julia W. Mason is an American pediatrician active in the anti-transgender “gender critical” movement. Mason is affiliated with anti-trans hate group Society for Evidence-Based Gender Medicine

If you are the parent or guardian of a gender diverse young person, do not take your family member to Mason for care. If you are a minor being forced to see Mason by unsupportive adults, do what you can to end treatment with Mason and seek out supportive local resources instead.

Background

Julia Robin Winter was born on March 19, 1966. Mason married Eliot C. Mason (born 1967).

Mason attended University of Illinois, earning a master’s degree and a medical degree in 1994. Mason did residency training in Pediatrics at Children’s Hospital Los Angeles from 1994 to 1997. Mason is licensed in Oregon, California, Minnesota, and Wisconsin. Mason is a board-certified pediatrician, a Fellow of the American Academy of Pediatrics, and currently practices at Calcagno Pediatrics in Gresham, Oregon.

Anti-transgender activism

Mason is involved with anti-trans organization Society for Evidence-Based Gender Medicine (SEGM). According to Mason, most gender diverse youth seen at Mason’s practice have “neurodevelopmental challenges or psychiatric comorbidities.”

AAP Resolution 33 (2021)

Introduced at the AAP Annual Leadership Forum 2021, this resolution “registered concern about the low quality of evidence underpinning treatment of minors with hormones and surgeries.”

AAP booth cancellation (2021)

SEGM tried to register a booth at the AAP conference in 2021, but it was rejected. Mason wrote the letter protesting the decision.

AAP Resolution 27 (2022)

Mason and four other pediatricians drafted Resolution 27 critical of AAP’s consensus on best practices for gender diverse youth. The authors are:

  • Julia W. Mason (Gresham, Oregon)
  • Sarah B. Palmer (Carmel, Indiana)
  • Paula Brinkley (Berkeley, California – Stanford Children’s)
  • Debra Hendrickson (Reno, Nevada – Northern Nevada Pediatrics)
  • Patrick K. Hunter (Milton, Florida – Pensacola Pediatrics)

AAP Resolution 37 (2023)

Mason again attempted to draft a resolution in 2023, which Mason claims is sponsored by 23 FAAP coauthors.

Wall Street Journal opinion and AAP response

Mason joined fellow anti-trans activist Leor Sapir in attacking mainstream pediatric organization American Academy of Pediatrics (AAP) for supporting gender affirming care for youth. In response, AAP President Moira Szilagyi stated:

Gender-affirming care can be lifesaving. It doesn’t push medical treatments or surgery; for the vast majority of children, it recommends the opposite.

This isn’t the story that is being told by anti-transgender activists. No European country has categorically banned gender-affirming care when medically appropriate. Contrary to what Dr. Mason and Mr. Sapir claim, the U.K. isn’t moving away from gender-affirming care. It is moving toward a more regional, multidisciplinary approach, similar to what is practiced in the U.S.

Mason frequently appears with other conservative and anti-trans activists, including:

References

Szilagyi, Moira (Aug. 21, 2022 ). Academy of Pediatrics Responds on Trans Treatment for Kids. Wall Street Journal https://www.wsj.com/articles/trans-gender-pediatric-aap-kids-children-care-surgery-affirm-treatment-11660942086

D’Ambrosio, Amanda (August 23, 2022). AAP Stands by Policy on Gender-Affirming Care for Trans Youth — Small group of pediatricians who called for evidence review charge they’re being sidelined. Medpage Today https://www.medpagetoday.com/special-reports/features/100352

O’Malley, Stella (August 23, 2022). At the American Academy of Pediatrics, ‘Affirmation’-Based Gender Dogma Is Finally Being Challenged. Quillette https://quillette.com/2022/08/23/challenge-to-affirmation-based-gender-dogma-at-american-academy-pediatrics/

Reinl, James (August 11, 2022). Leaked files expose how U.S. pediatricians accuse their own professional body of pushing a ‘harmful’ drugs-first approach on trans teens — and of deliberately BLOCKING moves to change the rules. Daily Mail https://www.dailymail.co.uk/news/article-11099561/Leaked-internal-files-pediatricians-angry-professional-bodys-transgender-policy.html

“Buttons, Christina” (July 9, 2023). The American Academy of Pediatrics sidelines formal proposal to revise Pediatric Medical Transition policy for the 4th consecutive year. buttonslives https://www.buttonslives.news/p/the-american-academy-of-pediatrics

Publications by Mason

Mason, JW (October 7, 2019). A physician is worried about gender transition in pediatrics. KevinMD https://www.kevinmd.com/2019/10/a-physician-is-worried-about-gender-transition-in-pediatrics.html

Pine, Elyse D.; Mason. Julia W. (April 28, 2021). Ban Hormones for Transgender Kids? Point-Counterpoint. Medscape https://www.medscape.com/viewarticle/950019

Mason, JW (August 3, 2021). [Letter to AAP protesting cancellation of SEGM booth]. SEGM https://segm.org/sites/default/files/AAP%20NCE%202021.pdf

Mason JW + 4 anonymous authors (March 31, 2022). Resolution 27 (2022): In Support of a Rigorous Systematic Review of Evidence and Policy 3 Update for Management of Pediatric Gender Dysphoria. https://transgender.agency/files/r27.pdf

Mason, Julia; Sapir, Leor (August 17, 2022). Opinion: The American Academy of Pediatrics’ Dubious Transgender Science. Wall Street Journal https://www.wsj.com/articles/the-american-academy-of-pediatrics-dubious-transgender-science-jack-turban-research-social-contagion-gender-dysphoria-puberty-blockers-uk-11660732791

Abbruzzese E, Levine SB, Mason JW (2023). The Myth of “Reliable Research” in Pediatric Gender Medicine: A critical evaluation of the Dutch Studies-and research that has followed. J Sex Marital Ther. 2023 Jan 2:1-27. https://doi.org/10.1080/0092623X.2022.2150346

Levine SB, Abbruzzese E, Mason JW (2023). What Are We Doing to These Children? Response to Drescher, Clayton, and Balon Commentaries on Levine et al., 2022. J Sex Marital Ther. 2023;49(1):115-125. https://doi.org/10.1080/0092623X.2022.2136117

Levine SB, Abbruzzese E, Mason JW (2022). Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults. J Sex Marital Ther. 2022;48(7):706-727. https://doi.org/10.1080/0092623X.2022.2046221

Malone WJ, Hruz PW, Mason JW, Beck S (2021). Letter to the Editor from William J. Malone et al: “Proper Care of Transgender and Gender-diverse Persons in the Setting of Proposed Discrimination: A Policy Perspective.” The Journal of Clinical Endocrinology & Metabolism Volume 106, Issue 8, August 2021, Pages e3287–e3288 https://doi.org/10.1210/clinem/dgab205

Media

Dumont, Joey (December 19, 2022). “Should we medicalize children?” with Dr. Julia Mason. True Thirty https://truethirty.substack.com/p/should-we-medicalize-children-with#details

Boyce, Benjamin (October 3, 2022). Saving Child Medicine from Gender Ideology | with Julia Mason. https://www.youtube.com/watch?v=3iAd6tSzSYE

Kelly, Megyn (Aug 4, 2022). The Truth About Puberty Blockers for Young Children, with Dr. Julia Mason and Dr. Erica Anderson. https://www.youtube.com/watch?v=KUjqO-u7X6c

Resources

Calcagno Pediatrics (calcagnopediatrics.com)

X/Twitter (x.com)

Note: this profile originally misstated Mason’s birthday.