Pediatric Medical Body Subpoenaed To Provide Florida With Documentation On Child Sex Change Policies
seng kui Lim via Getty Images

A federal judge has ordered a prominent pediatric medical group to provide Florida officials with documents explaining why it supports sex changes for children.

The demand of the American Academy of Pediatrics’ (AAP) was prompted by its participation in a federal lawsuit against a new Sunshine State law that bars the use of Medicaid to cover sex change procedures. The group is one of 18 facing subpoenas of documents and communications on guidelines and policies regarding youth medical transition from the Florida Agency for Health Care Administration (AHCA).

Other groups involved in the lawsuit include the American Academy of Child and Adolescent Psychiatry, American Medical Association, American Psychiatric Association, Pediatric Endocrine Society, Society for Adolescent Health and Medicine, and Yale University.

At an hour-long hearing last week, U.S. District Judge Carl J. Nichols narrowed the Florida agency’s request for “any” relevant records to those “sufficient to show” the AAP’s total membership, how it establishes guidelines and policy positions for child sex change treatments, as well as any “official communication” with their entire membership concerning the matter.

The AAP has until Feb. 2 to comply.

The order was the latest development in the case, brought by transgender rights groups with the backing of the medical groups and Yale. They are suing Florida, arguing its ban on Medicaid covering sex change treatments violates the Equal Protection Clause of the U.S. Constitution. 

The plaintiffs sought a preliminary injunction against the Medicaid ban, but the request was denied in October. Judge Robert Hinkle ruled that the ban did not violate constitutional rights, but instead would be determined by the Medicaid statute.

The AAP endorsed child sex change treatments in a 2018 policy statement, which was conceptualized, drafted, reviewed, revised, and approved by a single committee member, Dr. Jason Rafferty.

Leor Sapir, a Manhattan Institute fellow, charged that the AAP and other prominent organizations that favor child sex changes, which they euphemistically call “gender-affirming care,” lack evidence to back up their position and are at odds with a growing international consensus.

“On the issue of medical treatment for youth gender dysphoria in particular, American medical organizations have demonstrated a preference for ideologically driven conclusions over cautious review of the available research,” Sapir said.

According to Sapir, the AAP’s central conclusion is based on flawed logic and interpretations.

“Rafferty’s central claim in that article is that ‘watchful waiting,’ a therapeutic approach in which clinicians delay social and medical transition as long as possible in order to exhaust all efforts to help youth in distress feel comfortable in their bodies, is a form of ‘conversion therapy,’” said Sapir. The citations used to defend this claim had nothing to do with gender self-identification and were all based on the discredited practice of trying to get gay and lesbian adults to “convert” to heterosexuality.

Rafferty argued that clinicians should always “affirm” the gender self-declarations of their pediatric patients. In 2020, Dr. James Cantor of the Toronto Sexuality Centre published a thorough fact-check of Rafferty’s article in another journal. The fact-check revealed that the AAP policy contained “egregious omissions and misrepresentations of the available research on youth gender dysphoria,” said Sapir.

Florida is one of 10 states that does not allow state-sponsored insurance to cover elective sex change treatments. The state of Florida conducted a systematic review of the evidence in support of “gender-affirming” care and abandoned the practice after finding the costs far outweigh any purported benefits. Last November, Florida passed a rule that prohibits minors from receiving puberty blockers, cross-sex hormones, and gender-related surgeries.

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