Health
AGs Question Pediatricians Pushing Trans Treatment
From Heartland Daily News
In encouraging the use of puberty blockers, cross-sex hormones, and surgical interventions, the AAP claims the treatments are reversible. The AG letter says that is “misleading and deceptive.”
“It is beyond medical debate that puberty blockers are not fully reversible, but instead come with serious long-term consequences,”
Attorney generals from 20 states and legislators from Arizona signed an interrogatory letter to the president of the American Academy of Pediatrics (AAP) about the group’s support of puberty blockers, cross-sex hormones, and surgery for children and adolescents who have been diagnosed with gender dysphoria.
“Often the AAP has exercised its influence responsibly,” states the letter. “… But when it comes to treating children diagnosed with gender dysphoria, the AAP has abandoned its commitment to sound medical judgment.”
The AG letter demanded responses to multiple questions about its child gender policies by October 8, and it stated AAP’s conduct is being reviewed further.
Idaho Attorney General Raul R. Labrador sent the letter, and AGs from Alabama, Arkansas, Florida, Georgia, Iowa, Kansas, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, South Carolina, South Dakota, Texas, Utah, Virginia, and West Virginia signed it, as did the president of the Arizona State Senate and the speaker of the Arizona House.
Sounding an Alarm
The American College of Pediatricians (ACPeds), an alternative medical professional organization, has spent years sounding the alarm on AAP-approved transgender treatments.
ACPeds organized a coalition of health care professionals to create the Doctors Protecting Children Declaration, a document urging organizations to stop promoting what ACPeds calls unethical, harmful practices in treating children with gender dysphoria. Some 82,500 professionals and concerned citizens have signed the declaration.
“We have personally reached out to the AAP leadership and leaders of the other named organizations, asking them to put a stop to this, and have not received a response,” said ACPeds Executive Director Jill Simons, M.D.
“Unfortunately, the leadership of the AAP and other organizations have silenced their very members from engaging in medical discourse when they have put in question these harmful protocols, and they continue to double down on them even as they stand without evidence-based research to support their current positions,” said Simons.
Questioning What’s ‘Reversible’
In encouraging the use of puberty blockers, cross-sex hormones, and surgical interventions, the AAP claims the treatments are reversible. The AG letter says that is “misleading and deceptive.”
“It is beyond medical debate that puberty blockers are not fully reversible, but instead come with serious long-term consequences,” the letter states.
The letter cites the widely recognized Cass Review commissioned by Britain’s National Health Service and published in April.
“The Cass Review was monumental in demonstrating, through the most thorough review of the research and current protocols and outcomes in England, that the current protocols of social affirmation, puberty blockers, and cross-sex hormones do not improve the health outcomes of children with gender dysphoria and in fact there is evidence of causing harm,” said Simons.
“Dr. Hilary Cass’s recommendation has shut down the practice of transitioning kids in England,” said Simons. “Many other European countries are also reversing course and returning to proven medical care, which is supportive mental health and addressing underlying diagnoses.”
Leaked files from the World Professional Association of Transgender Health (WPATH) and a recent statement from the American Society of Plastics Surgeons have bolstered the case against surgical and hormonal trans treatments, says Simons.
APA, AMA Uninterested
A growing number of people are recognizing the validity of the studies, says Dr. Tim Millea, chair of the Health Care Policy Committee and Conscience Rights Protection Task Force of the Catholic Medical Association (CMA).
“Physician organizations such as AAP and [American Medical Association] appear to be uninterested in those studies, at the expense of ongoing harm to Americans that they encourage to enter the ‘gender-industrial’ medical system,” said Millea. “It seems to be true that the leadership of these groups prioritize ideology over science, which is a dereliction of duty in the vocation of medicine.”
Doctors Afraid to Speak Out
Most U.S. pediatricians are members of the AAP. Dissent within the organization has led to the development of alternative professional organizations such as ACPeds. The AAP is too radical for most pediatricians, though they are reluctant to say so, says Simons.
“I speak to countless pediatricians who are members of the AAP who disagree with the AAP’s policies and fully support our efforts to put a stop to these unethical protocols, but they are truly fearful of losing their jobs and the harms that will come to them if they speak out,” said Simons. “I unfortunately speak to pediatricians who have been reprimanded and even fired for speaking out.”
Going to Court
The AAP has been named in multiple lawsuits against doctors and hospitals. Members of ACPeds have served as expert witnesses and submitted amicus briefs to fight the AAP’s gender treatment protocols.
ACPeds also filed a lawsuit against the Biden-Harris administration for its rule requiring doctors to perform gender transition procedures on minors against their medical judgment.
“The American College of Pediatricians is filing this lawsuit against HHS because doctors should never be forced to violate their sound medical judgment and perform life-altering and sterilizing interventions on their patients,” stated ACPeds news release. “Our doctors take an oath to do no harm, but the Biden administration’s rule forces them to violate this oath and perform procedures that are harmful and dangerous to our patients– vulnerable children. What the Biden Administration is calling for is wrong and unlawful.”
Over the past several years, the CMA has been involved in gender intervention cases around the country and plans to file an amicus brief for the Supreme Court case United States v. Skrmetti, scheduled to be heard during the current session.
Changing the Culture
CMA hosted a two-hour panel discussion on September 8, 2024, in which several de-transitioners recounted the harms they suffered from gender transition procedures as minors. The organization wants to make sex-change procedures among children, teens, and young adults unthinkable, says Millea.
“There are three areas of emphasis to accomplish that goal, and two of them are judicial and legislative,” said Millea. “The third is of greatest importance, and that is cultural. The public needs to learn and understand the negative and lifelong risks and complications of gender transition.
“We remain hopeful that doctors will push back against these protocols and follow their oath to do no harm,” said Simons. “There will be a tipping point when doctors are no longer fearful and will speak out.”
Ashley Bateman ([email protected]) writes from Virginia.
Nurse practitioners expand primary care access |
The Alberta government’s Nurse Practitioner Primary Care program is showing early signs of success, with 33 nurse practitioners already practising independently in communities across the province.
Alberta’s government is committed to strengthening Alberta’s primary health care system, recognizing that innovative approaches are essential to improving access. To further this commitment, the Nurse Practitioner Primary Care Program was launched in April, allowing nurse practitioners to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.
Since being announced, the program has garnered a promising response. A total of 67 applications have been submitted, with 56 approved. Of those, 33 nurse practitioners are now practising autonomously in communities throughout Alberta, including in rural locations such as Beaverlodge, Coaldale, Cold Lake, Consort, Morley, Picture Butte, Three Hills, Two Hills, Vegreville and Vermilion.
“I am thrilled about the interest in this program, as nurse practitioners are a key part of the solution to provide Albertans with greater access to the primary health care services they need.”
To participate in the program, nurse practitioners are required to commit to providing a set number of hours of medically necessary primary care services, maintain a panel size of at least 900 patients, offer after-hours access on weekends, evenings or holidays, and accept walk-in appointments until a panel size reaches 900 patients.
With 33 nurse practitioners practising independently, about 30,000 more Albertans will have access to the primary health care they need. Once the remaining 23 approved applicants begin practising, primary health care access will expand to almost 21,000 more Albertans.
“Enabling nurse practitioners to practise independently is great news for rural Alberta. This is one more way our government is ensuring communities will have access to the care they need, closer to home.”
“Nurse practitioners are highly skilled health care professionals and an invaluable part of our health care system. The Nurse Practitioner Primary Care Program is the right step to ensuring all Albertans can receive care where and when they need it.”
“The NPAA wishes to thank the Alberta government for recognizing the vital role NPs play in the health care system. Nurse practitioners have long advocated to operate their own practices and are ready to meet the growing health care needs of Albertans. This initiative will ensure that more people receive the timely and comprehensive care they deserve.”
The Nurse Practitioner Primary Care program not only expands access to primary care services across the province but also enables nurse practitioners to practise to their full scope, providing another vital access point for Albertans to receive timely, high-quality care when and where they need it most.
Quick facts
- Through the Nurse Practitioner Primary Care Program, nurse practitioners receive about 80 per cent of the compensation that fee-for-service family physicians earn for providing comprehensive primary care.
- Compensation for nurse practitioners is determined based on panel size (the number of patients under their care) and the number of patient care hours provided.
- Nurse practitioners have completed graduate studies and are regulated by the College of Registered Nurses of Alberta.
- For the second consecutive year, a record number of registrants renewed their permits with the College of Registered Nurses of Alberta (CRNA) to continue practising nursing in Alberta.
- There were more than 44,798 registrants and a 15 per cent increase in nurse practitioners.
- Data from the Nurse Practitioner Primary Care Program show:
- Nine applicants plan to work on First Nations reserves or Metis Settlements.
- Parts of the province where nurse practitioners are practising: Calgary (12), Edmonton (five), central (six), north (three) and south (seven).
- Participating nurse practitioners who practise in eligible communities for the Rural, Remote and Northern Program will be provided funding as an incentive to practise in rural or remote areas.
- Participating nurse practitioners are also eligible for the Panel Management Support Program, which helps offset costs for physicians and nurse practitioners to provide comprehensive care as their patient panels grow.
Related information
Addictions
BC Addictions Expert Questions Ties Between Safer Supply Advocates and For-Profit Companies
By Liam Hunt
Canada’s safer supply programs are “selling people down the river,” says a leading medical expert in British Columbia. Dr. Julian Somers, director of the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University, says that despite the thin evidence in support of these experimental programs, the BC government has aggressively expanded them—and retaliated against dissenting researchers.
Somers also, controversially, raises questions about doctors and former health officials who appear to have gravitated toward businesses involved in these programs. He notes that these connections warrant closer scrutiny to ensure public policies remain free from undue industry influence.
Safer supply programs claim to reduce overdoses and deaths by distributing free addictive drugs—typically 8-milligram tablets of hydromorphone, an opioid as potent as heroin—to dissuade addicts from accessing riskier street substances. Yet, a growing number of doctors say these programs are deeply misguided—and widely defrauded.
Ultimately, Somers argues, safer supply is exacerbating the country’s addiction crisis.
Somers opposed safer supply at its inception and openly criticized its nationwide expansion in 2020. He believes these programs perpetuate drug use and societal disconnection and fail to encourage users to make the mental and social changes needed to beat addiction. Worse yet, the safer supply movement seems rife with double standards that devalue the lives of poorer drug users. While working professionals are provided generous supports that prioritize recovery, disadvantaged Canadians are given “ineffective yet profitable” interventions, such as safer supply, that “convey no expectation that stopping substance use or overcoming addiction is a desirable or important goal.”
To better understand addiction, Somers created the Inter-Ministry Evaluation Database (IMED) in 2004, which, for the first time in BC’s history, connected disparate information—i.e. hospitalizations, incarceration rates—about vulnerable populations.
Throughout its existence, health experts used IMED’s data to create dozens of research projects and papers. It allowed Somers to conduct a multi-million-dollar randomized control trial (the “Vancouver at Home” study) that showed that scattering vulnerable people into regular apartments throughout the city, rather than warehousing them in a few buildings, leads to better outcomes at no additional cost.
In early 2021, Somers presented recommendations drawn from his analysis of the IMED to several leading officials in the B.C. government. He says that these officials gave a frosty reception to his ideas, which prioritized employment, rehabilitation, and social integration over easy access to drugs. Shortly afterwards, the government ordered him to immediately and permanently delete the IMED’s ministerial data.
Somers describes the order as a “devastating act of retaliation” and says that losing access to the IMED effectively ended his career as a researcher. “My lab can no longer do the research we were doing,” he noted, adding that public funding now goes exclusively toward projects sympathetic to safer supply. The B.C. government has since denied that its order was politically motivated.
In early 2022, the government of Alberta commissioned a team of researchers, led by Somers, to investigate the evidence base behind safer supply. They found that there was no empirical proof that the experiment works, and that harm reduction researchers often advocated for safer supply within their studies even if their data did not support such recommendations.
Somers says that, after these findings were published, his team was subjected to a smear campaign that was partially organized by the British Columbia Centre on Substance Use (BCCSU), a powerful pro-safer supply research organization with close ties to the B.C. government. The BCCSU has been instrumental in the expansion of safer supply and has produced studies and protocols in support of it, sometimes at the behest of the provincial government.
Somers is also concerned about the connections between some of safer supply’s key proponents and for-profit drug companies.
He notes that the BCCSU’s founding executive director, Dr. Evan Wood, became Chief Medical Officer at Numinus Wellness, a publicly traded psychedelic company, in 2020. Similarly, Dr. Perry Kendall, who also served as a BCCSU executive director, went on to found Fair Price Pharma, a now-defunct for-profit company that specializes in providing pharmaceutical heroin to high-risk drug users, the following year.
While these connections are not necessarily unethical, they do raise important questions about whether there is enough industry regulation to minimize potential conflicts of interest, whether they be real or perceived.
The BCCSU was also recently criticized in an editorial by Canadian Affairs, which noted that the organization had received funding from companies such as Shoppers Drug Mart and Tilray (a cannabis company). The editorial argued that influential addiction research organizations should not receive drug industry funding and reported that Alberta founded its own counterpart to the BCCSU in August, known as the Canadian Centre of Recovery Excellence, which is legally prohibited from accepting such sponsorships.
Already, private interests are betting on the likely expansion of safer supply programs. For instance, Safe Supply Streaming Co., a publicly traded venture capital firm, has advertised to potential investors that B.C.’s safer supply system could create a multi-billion-dollar annual market.
Somers believes that Canada needs more transparency regarding how for-profit companies may be directly or indirectly influencing policy makers: “We need to know exactly, to the dollar, how much of [harm reduction researchers’] operating budget is flowing from industry sources.”
Editor’s note: This story is published in syndication with Break The Needle and Western Standard.
The Bureau is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
Dr. Julian M. Somers is director of the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University. He was Director of the UBC Psychology Clinic, and past president of the BC Psychological Association. Liam Hunt is a contributing author to the Centre For Responsible Drug Policy in partnership with the Macdonald-Laurier Institute.
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