February 28, 2022

 

On behalf of the Pediatric Endocrine Society, the main academic and professional society of pediatric endocrinologists in North America with more than 1500 members, we write this letter to oppose the recent directive by Governor Greg Abbott ordering the Department of Family and Protective Services (DFPS) to investigate any reported instances of Texas children receiving gender-affirming care as “child abuse.”

This policy goes against the medical evidence1-7 which has shown that these treatments may be lifesaving by improving mental health and decreasing the risk of suicide in transgender youth. Enforcement of this directive with investigations of parents, as well as health professionals who provide gender-affirming medical care, may lead to significant harm of Texas children and their families. Families and youth need to be allowed to make these individual decisions under the care of trained medical and mental health professionals without interference from politicians. We are deeply concerned that children and adolescents may be harmed by your decision to deny gender-affirming care and lead to worsening of mental health illness and suicide risk in this already vulnerable population as a consequence of the directive.

We have previously released several statements supporting gender-affirming care in transgender youth and have expressed our opposition to bills and other efforts that ban this potential life-saving care and urge you to revoke this directive.

 

Thank you for your consideration,

Sharon Oberfield, MD

PES President

 

References:

  1. de Vries AL, McGuire JK, Steensma TD, Wagenaar EC, Doreleijers TA, Cohen-Kettenis PT. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. Oct 2014;134(4):696-704. doi:10.1542/peds.2013-2958
  2. Kuper LE, Stewart S, Preston S, Lau M, Lopez X. Body Dissatisfaction and Mental Health Outcomes of Youth on Gender-Affirming Hormone Therapy. Pediatrics. Apr 2020;145(4)doi:10.1542/peds.2019-3006
  3. Achille C, Taggart T, Eaton NR, et al. Longitudinal impact of gender-affirming endocrine intervention on the mental health and well-being of transgender youths: preliminary results. Int J Pediatr Endocrinol. 2020;2020:8. doi:10.1186/s13633-020-00078-2
  4. Aldridge Z, Patel S, Guo B, et al. Long term effect of gender affirming hormone treatment on depression and anxiety symptoms in transgender people: A prospective cohort study. Andrology. Aug 10 2020;doi:10.1111/andr.12884
  5. Turban JL, King D, Carswell JM, Keuroghlian AS. Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. Pediatrics. Feb 2020;145(2)doi:10.1542/peds.2019-1725
  6. Costa R, Dunsford M, Skagerberg E, Holt V, Carmichael P, Colizzi M. Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria. J Sex Med. Nov 2015;12(11):2206-14. doi:10.1111/jsm.13034
  7. Olson-Kennedy J, Warus J, Okonta V, Belzer M, Clark LF. Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults: Comparisons of Nonsurgical and Postsurgical Cohorts. JAMA Pediatr. May 1 2018;172(5):431-436. doi:10.1001/jamapediatrics.2017.5440
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