October 5, 2022 - 10:10am

This week, the American Academy of Pediatrics (AAP), American Medical Association and Children’s Hospital Association wrote to the US Attorney General in support of physicians and hospitals who have been threatened and attacked in recent months. At first glance, this is a noble and worthy aim — threats and acts of violence are to be deplored wherever they occur. But their demands are open-ended and as such should ring alarm bells in the minds of anyone who values free speech.

The context for the letter is so-called “evidence-based gender-affirming health care” for “Transgender and Gender-Diverse Children and Adolescents”. The AAP cited their own policy statement that defined gender affirmation to include puberty blockers, cross-sex-hormone therapy and “gender affirming surgeries”. These are controversial treatment protocols to say the least, and a heated debate has erupted across social media. But rather than engage with criticism, the three organisations seem to want to shut it down. In their letter they insisted:

The attacks are rooted in an intentional campaign of disinformation, where a few high-profile users on social media share false and misleading information targeting individual physicians and hospitals.
- American Academy of Pediatrics, American Medical Association and Children’s Hospital Association

But what is ‘disinformation’? Is it simply information that these three large organisations do not like? They are certainly very quick to make assertions of their own — the AAP talks about ‘evidence-based gender-affirming health care’ as if the efficacy of these treatments had been proven by extensive clinical trials — but they seem less keen to face questions. Dismissing contrary views as false or misleading sounds alarmingly like those Trumpian claims of fake news.

On this side of the Atlantic we do things differently. NHS England commissioned Dr Hilary Cass to review Gender Identity Services for Children and Young People. In paragraph 5.21 of her interim report, she came to a more considered conclusion:

The lack of available high-level evidence was reflected in the recent NICE review into the use of puberty blockers and feminising/masculinising hormones commissioned by NHS England, with the evidence being too inconclusive to form the basis of a policy position.
- Dr Hilary Cass

Disinformation? Or expert opinion? It’s not clear who makes the call. In a democratic society, arguments are debated and opponents are persuaded. But the letter writers take a rather different approach:

Our organizations have called on technology companies to do more to prevent this practice on digital platforms, and we now urge your office to take swift action to investigate and prosecute all organizations, individuals, and entities responsible.
- American Academy of Pediatrics, American Medical Association and Children’s Hospital Association

This has the hallmarks of an authoritarian pincer movement — the censors on one side and the thought police on the other — to protect an industry that medically transitions children from scrutiny. If that industry gets its way, the impact on investigative journalism may be profound, while the implications for children are terrifying.  

Debbie Hayton is a teacher and a transgender campaigner.