What is it about?
Although most American medical societies have endorsed puberty blockers, cross-sex hormones, and surgeries for gender-dysphoric minors, there is actually no reliable evidence to suggest these treatments are (quoting from a recent American Journal of Psychiatry article by Breslow et al.) “essential” or “lifesaving.”
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Why is it important?
In this Letter we respond to Breslow et al.’s characterization of pediatric medical transition as essential, lifesaving care. Breslow et al. think that organized psychiatry should respond to age-limit legislation by ramping up our advocacy for these treatments. We disagree- advocacy should follow evidence. Instead of cheerleading pediatric medical transition, the APA and other organizations should reconsider their stance on this issue and issue clinical guidance that is consistent with evidence-based medicine and basic principles of medical ethics. Course correction will be difficult in an academic culture in which criticism of pediatric medical transition has been censored or punished. However, we have to do it anyway.
Perspectives
I hope this article, which I authored with my child psychiatrist colleague, emboldens psychiatrists to engage in robust discussion of this important issue. We are happy that a critical perspective on pediatric medical transition has finally been published in the AJP. We urge those in leadership positions to consider how the APA’s strong endorsement of these interventions, which lack an adequate evidence base, reflects on its stated scientific commitments, and how it may impact public trust in psychiatry.
Kathleen McDeavitt
Baylor College of Medicine
Read the Original
This page is a summary of: Pediatric Gender Medicine: Psychiatry’s Duty to Model Respectful Disagreement, American Journal of Psychiatry, August 2026, American Psychiatric Association,
DOI: 10.1176/appi.ajp.20260075.
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