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The American College of Pediatricians (ACPeds)—a socially conservative association of pediatricians and healthcare professionals in the United States, founded in 2002—has issued the following statement on gender identity in children. The bold highlighting below is mine.

American_College_of_Pediatricians_(emblem)The American College of Pediatricians urges educators and legislators to reject all policies that condition children to accept as normal a life of chemical and surgical impersonation of the opposite sex. Facts – not ideology – determine reality.

1. Human sexuality is an objective biological binary trait: “XY” and “XX” are genetic markers of health – not genetic markers of a disorder. The norm for human design is to be conceived either male or female. Human sexuality is binary by design with the obvious purpose being the reproduction and flourishing of our species. This principle is self-evident. The exceedingly rare disorders of sexual differentiation (DSDs), including but not limited to testicular feminization and congenital adrenal hyperplasia, are all medically identifiable deviations from the sexual binary norm, and are rightly recognized as disorders of human design. Individuals with DSDs do not constitute a third sex.

2. No one is born with a gender. Everyone is born with a biological sex. Gender (an awareness and sense of oneself as male or female) is a sociological and psychological concept; not an objective biological one. No one is born with an awareness of themselves as male or female; this awareness develops over time and, like all developmental processes, may be derailed by a child’s subjective perceptions, relationships, and adverse experiences from infancy forward. People who identify as “feeling like the opposite sex” or “somewhere in between” do not comprise a third sex. They remain biological men or biological women.

3. A person’s belief that he or she is something they are not is, at best, a sign of confused thinking. When an otherwise healthy biological boy believes he is a girl, or an otherwise healthy biological girl believes she is a boy, an objective psychological problem exists that lies in the mind not the body, and it should be treated as such. These children suffer from gender dysphoria. Gender dysphoria (GD), formerly listed as Gender Identity Disorder (GID), is a recognized mental disorder in the most recent edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-V). The psychodynamic and social learning theories of GD/GID have never been disproved.

4. Puberty is not a disease and puberty-blocking hormones can be dangerous. Reversible or not, puberty- blocking hormones induce a state of disease – the absence of puberty – and inhibit growth and fertility in a previously biologically healthy child.

5. According to the DSM-V, as many as 98% of gender confused boys and 88% of gender confused girls eventually accept their biological sex after naturally passing through puberty.

6. Children who use puberty blockers to impersonate the opposite sex will require cross-sex hormones in late adolescence. Cross-sex hormones are associated with dangerous health risks including but not limited to high blood pressure, blood clots, stroke and cancer.

7. Rates of suicide are twenty times greater among adults who use cross-sex hormones and undergo sex reassignment surgery, even in Sweden which is among the most LGBQT – affirming countries. What compassionate and reasonable person would condemn young children to this fate knowing that after puberty as many as 88% of girls and 98% of boys will eventually accept reality and achieve a state of mental and physical health?

8. Conditioning children into believing a lifetime of chemical and surgical impersonation of the opposite sex is normal and healthful is child abuse. Endorsing gender discordance as normal via public education and legal policies will confuse children and parents, leading more children to present to “gender clinics” where they will be given puberty-blocking drugs. This, in turn, virtually ensures that they will “choose” a lifetime of carcinogenic and otherwise toxic cross-sex hormones, and likely consider unnecessary surgical mutilation of their healthy body parts as young adults.

Michelle A. Cretella, M.D.
President of the American College of Pediatricians

Quentin Van Meter, M.D.
Vice President of the American College of Pediatricians
Pediatric Endocrinologist

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

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17 thoughts on “8 Points from the American College of Pediatricians on Gender Identity in Children”

  1. Ken Abbott says:

    Nice to have some professionals take a stand, but the much smaller and far younger ACP lacks the academic standing of the American Academy of Pediatrics, which is the professional society of most US pediatricians. In other words, the statement is good so far as it goes, but it won’t go far.

    1. It’s important to note that the doctors who formed the much smaller American College of Pediatricians (ACPed) chose to do so because of the politicization of the much larger, more well-known American Academy of Pediatrics (AAP). The small size of ACPed is used by “progressives” as a fallacious argumentum ad populum argument to undermine the credibility of ACPeds. It’s important to note the inconvenient truth for “progressives” that not all members of AAP endorse its formal positions on homosexuality and gender dysphoria.

      ACPed was founded after AAP released a report endorsing same-sex adoption, a paper that was written by two people, aided and abetted by a small committee who contributed I know not what. This paper did not address the most salient issues relative to children adopted by homosexuals (whose couplings are by nature and design non-procreative). There is no hard science proving the absence of long-term ill-effects on children from being denied either a mother or a father. And there is no hard science proving that children have no intrinsic right to be raised whenever possible by a mother and a father, preferably their own biological parents. If these issues stand outside the purview of the AAP, then perhaps they ought not take a formal (and radical) position on an issue of such profound significance.

      1. Ken Abbott says:

        Believe me, I’m quite aware of the politicization of the major medical specialty societies. Run as they mainly are by academic elites, they reflect the groupthink of the leadership far more than the broad diversity of the vast majority of “in the trenches” practicing physicians. My object was to make sure people don’t confuse the ACP with the AAP and think that suddenly academic pediatrics has come to its collective senses.

  2. Bobbi Brown says:

    As an adult my cousin decided that he is no longer a man but feels he is a woman. I pray for him. His sister has been fooled as well.

  3. Sandra Grammer says:

    Thank you. Just thank you.

  4. David says:

    Does “deviations from the sexual binary norm” mean that such a person is neither male nor female?

  5. Manuel Reyes says:

    This is just hitting straight to the point! Great job ACPeds!

  6. Tenderrlee says:


  7. Philmonomer says:

    This quote below calls into question the entire validity of the “American College of Pediatricians.”:

    7. Rates of suicide are twenty times greater among adults who use cross-sex hormones and undergo sex reassignment surgery, even in Sweden which is among the most LGBQT – affirming countries. What compassionate and reasonable person would condemn young children to this fate knowing that after puberty as many as 88% of girls and 98% of boys will eventually accept reality and achieve a state of mental and physical health?

    The authors of that study themsevles explicitly stated that

    In other words, the results should not be interpreted such as sex reassignment per se increases morbidity and mortality. Things might have been even worse without sex reassignment. As an analogy, similar studies have found increased somatic morbidity, suicide rate, and overall mortality for patients treated for bipolar disorder and schizophrenia. This is important information, but it does not follow that mood stabilizing treatment or antipsychotic treatment is the culprit.

    Anyone using the results in the way they have been used here is more interested in their own ideology, rather than the truth.

    1. James Adger says:

      The difference is that the statistics show that those with Gender Dysphoria at a young age (the 98% of boys and 88% of girls statistic) accept their biological sex after puberty, so to block the puberty process when in all likelihood, the dysphoria will no longer be the case with the child, is ridiculous. Comparing it to the bipolar disorder or schizophrenia doesn’t really work because those disorders don’t go away 88-98% of the time.

  8. creekmama says:

    I am so thankful that in our present climate of moral confusion that at least some medical professionals are speaking the truth about transgender issues and children.

  9. Philmonomer says:

    Here is a question:

    If my wife suffered from Androgen Insensitivity Syndrome, (AIS), such that she is, genetically speaking, without a doubt a man (XY Chromosomes), should I be allowed to marry her?

    (BTW, this condition affects 20,000-30,000 people in the US alone.)

    1. To Philmonomer: AIS (partial or complete) is among the sexual differentiation disorders that the American College of Pediatricians referenced. These conditions are, as you likely know, commonly referred to as intersex conditions, which are wholly different from gender dsyphoria in persons who have no genetic or biochemical anomalies.” “Progressives” like to conflate the two because it serves their strategic purposes.

      1. Philmonomer says:

        First, that doesn’t answer my question.

        Second, as far as I can tell, sometimes people with gender dysphoria have genetic or biochemical anomalies, sometimes they don’t (actually, I’m willing to bet they always have some sort of biochemical anomaly–hence the gender dysphoria, but I don’t know enough to say that definitively.)

        Are you saying it is ok to accept “as normal a life of chemical and surgical impersonation of the opposite sex” so long as there is some sort of genetic or biochemical anomaly?

  10. Philosopher says:


    Doubtless, we live in a fallen world where such situations exist. The extent to which the fall has ravaged human health is exhibited in AIS in that it has affected us down to even the basic nature of our our creation as male and female. I’ll take you even further. Congenital adrenal hyperplasia and other lesser-known disorders can cause ambiguous genitalia, meaning that the parents of the child have to make a decision on whether to raise the child as a boy or girl. This decision is fraught with long-term psychological consequences. Is there a right answer in this situation?

    While we could argue from the margins using examples such as CAH or AIS, it would be using the exceptions to define the rule. For the roughly 7 billion people of the world that are not affected by these disorders, it seems better to argue from the normal paradigm of genotypic and phenotypic XY and XX rather than the disorders of CAH and AIS. Are there rare situations that take wisdom and discernment? Yes. There may be situations with AIS where an XY individual lives as a female due to the nature of the genetic disorder and its phenotypic consequences, and she even marries a man. Should such a situation define the experience and the rightness of such a similar experience for the 99.9999% of us without such an underlying genetic disorder? No.

    Now, if someone wanted to argue that science shows support for a genetic determinant of an individual being transgender, and thus, based on that gene, a similar situation exists for all the transgender individuals, then such a person of science will be hard pressed to find a paper that proves causation. There are clear causative links in AIS and CAH. While there is genetic research on transgender individuals in both the MTF and FTM direction, there is no causative proof, only associations. So the analogy does not hold.

    Regarding the ACPed statement, it is impressive that McHugh signed it. He has shown previously that he’s not afraid to buck the trend. He doesn’t care much for the DSM method of Psychiatry and doesn’t give it the same weight as many in his field. I find his Perspectives model helpful.

  11. Duane Kelley says:

    Please cite links to all the articles listed, without them this is just another biased op-ed from a biased organization. I am working in a teen health center and have to deal with this on occasion and am open to all scientific points of view. Thanks.

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Justin Taylor, PhD

Justin Taylor is executive vice president of book publishing and book publisher for Crossway and blogs at Between Two Worlds. You can follow him on Twitter.

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