James Cantor shreds American Academy of Peds gender-affirmative policy statement

Anyone who is paying attention knows the US holds the dubious distinction of being the world’s incubator for the “gender affirmative” approach. This treatment pathway–increasingly, the only pathway available in the United States–frequently consists of:

  • full social transition for children, starting as young as toddlerhood;
  • cross-sex hormones and even “top” and “bottom” surgeries for young teens, some of whom showed no childhood gender discomfort and only announced a trans identity in adolescence; and
  • affirmation of a child’s trans identity at any age, regardless of other possible causative/related factors (such as autism, social contagion, or same-sex attraction). Some of the more fervent US clinicians eschew careful psychological assessment before they prescribe full social and/or medical transition, asserting that such thorough evaluation is unnecessarily onerous or “triggering” to the young patient.

The American Academy of Pediatrics recently released a policy statement  which essentially rubber-stamps the affirmative approach. (While the Academy itself has tens of thousands of members, a recent article pointed out that the policy document was the work of a very small, activist-inspired subgroup). The AAP document creates the impression that affirmative treatment is a matter of settled clinical consensus.

Nothing could be further from the truth.

The AAP policy has a number of glaring flaws. To take just one example, it omits a significant body of research evidence that is inconvenient to the AAP’s affirmation-only doctrine. Worse: the research the AAP document does cite ironically substantiates the very “watchful waiting” approach dismissed by the AAP. The truth is, this more cautious approach is the most commonly used and evidence-based treatment for childhood gender dysphoria recognized by clinicians around the world.

There’s a lot more to pick apart in the AAP’s policy statement, and James Cantor, PhD., a Toronto-based sexologist, researcher, and clinical psychologist, did just that today. His long (but worth it) fact-checking article is required reading for anyone interested in the topic of pediatric transition.

Please read and share Dr. Cantor’s piece widely. You can read the whole thing here.

Cantor sex today lead aap

23 thoughts on “James Cantor shreds American Academy of Peds gender-affirmative policy statement

  1. It’s worth noting that when this was reported in the New York Times a few days ago, the majority of comments on the story were pretty horrified. And this is Uber-liberal New York. It seems even here the radical trans movement is very much a small minority, albeit a loud one that conflates and weaponizes the language of civil rights the moral high ground.

    Liked by 7 people

  2. Seen on Ray Blanchard’s Twitter feed today:
    ‘It would be interesting to know exactly who really wrote (or ghost-wrote) this document, who was responsible for the “research,” and who contributed ideas or blocks of written material to its contents. Do the AAP rank-and-file members care?”

    Liked by 3 people

  3. The research and fact checking done by Dr. Cantor is extraordinary! What can we all do collectively to support him/hold AAP accountable? Should we be all writing letters to AAP? Thoughts?

    Liked by 1 person

  4. Good luck with writing a letter. I did on October 2. Here it is. I have heard nothing back.October 2, 2018. I find the whole “definitions” section to be insulting and suspect.


    American Academy of Pediatrics National Headquarters
    ATTN: Dr. Rafferty
    RE: Ensuring Comprehensive Care and Support for Transgender and Gender Diverse Children and Adolescents
    345 Park Boulevard
    Itasca, IL 60143

    Dear AAP, Doctor Rafferty or who actually reads the mail,

    I recently read your new guidelines Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents online at http://pediatrics.aappublications.org/content/142/4/e20182162. (October 2018)

    At what point did the medical profession become the authority on the “social construct” of gender and deem it their prerogative to medically intervene on children and adolescents with their internal struggles to conform to certain cultural and fashion expectations? In other words, can you provide me with how these guidelines have changed over the last few decades and when gender became defined as this psychological construct, seemingly divorced from biological sex? What is the actual scientific evidence behind such a definition of gender?

    From your publication:

    “Gender identity A person’s deep internal sense of being female, male, a combination of both, somewhere in between, or neither, resulting from a multifaceted interaction of biological traits, environmental factors, self-understanding, and cultural expectations”

    Furthermore, I find it odd that your paper did not delve into the etiology of the current wave of transgenderism among youth in “first world” countries. What is the cause of this rapid rise especially among adolescent girls? Is there any research into perhaps the genealogy of the families, personal habits or environmental factors that can cause this desire for medicating physically healthy children and adolescents? I find it odd that you do not have any ethical concerns about medicating youth based on “cultural expectations.”

    I await your reply,


    Paul xxxxx

    Liked by 6 people

    • “At what point did the medical profession become the authority on the “social construct” of gender and deem it their prerogative to medically intervene on children and adolescents with their internal struggles to conform to certain cultural and fashion expectations?”



  5. This latest NYT item gave me pause and thought others here might be interested as well. While discussing the pediatrics article above with my brother, I immediately got accused of being a right-winger, having “lots in common with Donald Trump and Brett Kavanaugh,” blah blah. All of this is completely untrue, but I found it hard to explain, exactly, how I was not aligned with the right on this issue—and I think it matters NOT to be.

    Ditto this new Trump administration policy, where I agree with some of the basic ideas (people can’t change sex — check! Men shouldn’t be on women’s sports teams or use their bathrooms — check!) without having the same politico-religious impulse to trample on the civil rights or social acceptance of sexual minorities. How do we walk that line? Anyway, maybe food for another post on this forum. I just didn’t see another place to put it.

    Liked by 1 person

    • Elizabeth, I agree with you about the new policy that has been batted about by the current administration… while I agree with it in parts, I do believe they have crossed the line. It’s definitely too rigid. I believe there are some people who are truly transgender, and have been from a very young age and it’s an obvious distinction. Some of them grow up and do SRS, and for them, transitioning completely is the right thing to do. I have no problem with that. I do however have a problem when the impulse to transition suddenly comes about in adolescence, when children are at their most vulnerable. We’re on the same page here.
      Moreover, I have these beliefs because of my own personal experience as a GD child at less than 13 years of age, and of my own ROGD child too.
      I’m sure that had I been a child now, having gender dysphoria in this day and age, I may have been swept up into the total transition pathway, but would have somehow wriggled free from that destination. I was not transgender in the truest sense, It was not right for me back then, and it wouldn’t be right if it happened now. I grew out of my GD, and am so glad I did. I’m definitely not a man, and I’m very heterosexual. I get physically ill if I think of the alternative. But in my child’s case, she definitely has ROGD – and has been swept up by the current attitudes of the times.


      • As much as I despise much of what is coming out, thanks to the POTUS and his congress of cretins, this may be the most logical response to what the brigade has been putting forth.

        If the reactions to the onslaught of the laws that have been enacted was to be ‘soft’, then other laws will be put into place. Other persons will be damaged, in particular children, who will be mistreated by physicians and mental health professionals, who want to be fair. Even though it is a fact that children lack the overall mental capability to understand gender roles overall. WHY????Because they are children, who are still trying to figure out how their bodies work, let alone who are those ‘giants’ in the house, who are giving instructions. And the items that the brigade wants to force on the world,via the APA, etc need to be met head on.

        Think of this in the following terms: if nothing is done now, in about 20 years time, the healthcare system in the US, which will ALREADY be over-stressed by the health care problems of the later baby-boom generation, will then be swamped by brainwashed brigade members. The ones who ‘chose’ to go this particular route, via chemicals, will now flood the system with cases of renal failure, cardiac failure, strokes, liver failure….at earlier ages than before [I am loathe to mention one other item, but may as well: obesity, which happens due to the fact that the HRT, in more cases than not, causes a massive misfire of the endocrine system and others….hence, more fat is accrued, but is not disposed of, by the damaged system in the body, that under ordinary circumstances, would be able to mitigate the damage]. This flood will lead to rather ugly forms of triage, so much so, that it is possible, that the well-funded by known creeps brigade, will insure their members get treated better [based on those ‘feels’] than the rank and file. Imagine parents fighting their own offspring over who gets what treatment, which insurance coverage will be take to cover all of this. And this is BEFORE we get to the scenarios involving MENTAL HEALTH [where thanks to the brigade’s pushing….there are ALREADY more children on SSRI’s/AD’s than before in recorded history…outside of those who were on them, due to behavioral issues…and that is another kettle of worms on it’s own accord].

        Anyone who says that the above cannot happen or is highly unlikely to happen, if there are no halts done now, keep in mind many out there did not think the colleges and unis would become incubators of intolerance.for anyone who was/is not PC. Hence…while what POTUS wants to do may seem an extreme fix, let what is mentioned in the above paragraph roll around for a few. Better to apply an extreme remedy now, than have many more innocent persons pay for it later on.


    • When I saw this article yesterday, I noticed that a quote from the memo talks about the definition of “sex” while the article (and activists) talk about “gender”. This constant language manipulation is frustrating. Gender and gender expression are protected by non-discrimination laws; but why on Earth biological sex on birth certificates should be mutable? And if somebody had a face lift, should they be allowed to change their year of birth too?

      Liked by 3 people

    • I am not interested in arguing about politics. I think the constant urge to make every single thing political is one reason we’re at the point where we’re at — especially on this particular issue.

      However, I have this to say about anyone who wants to complain about the issue with the Trump administration memo.

      The purpose of Title IX and VII are to protect against discrimination due to sex. When the laws were passed, in the 70s, the definition and understanding of “sex” was that of biological, verifiable sex — whether a person was male or female.

      What the NYT is putting on blast, first of all, is a MEMO. Second, the reason that memo exists at all is becuase the Obama administration issues a “guidance letter” where it was noted that the administration believed that “gender” (which, BTW, has never been defined specifically) is covered by Title IX and VII. Magically, BTW. The word gender is not in either law. There have been some lower-court cases which have conflated it. It’s obviously something politicians and judges want to have happen — include “gender” as a protected class. They do not, however, want to either change the law or make new ones. I would say because they know that it will not fly with the vast majority of Americans, regardless of political leaning.

      The way the Obama administration played this — as an executive order — is not actually enforceable as a law. It’s NOT a law. The Trump administration memo first of all, isn’t a law, either. IT’S A MEMO. It’s a discussion about this situation — that the waters on Title IX and VII have been muddied and how to possibly go about dealing with that. The first step was when the administration rescinded the guidance letter. Now they appear to be saying, “A statement about the actual text and meaning of the law is that the law is about SEX and protecting against discrimination due to that factor alone.”

      The real issue at base is that this is what politics IS. It’s creating common cause about important things, even if you disagree about other important things. Even if you disagree about WHY. Politics is about defining something (specifically) and how to agree on treatment. I don’t consider myself either liberal or a radical feminist. I know the arguments for both side (and the arguments from both sides against the others. I personally understand that humans beings are either male or female — a designation based on the human reproductive system. For most of human history, women, due to their role in reproduction, are smaller and weaker physically and have been oppressed because of that fact alone. Not educated. Not allowed to work. Seen as less-than-human. Western society and laws have worked toward social and legal equality of women. Things are MUCH BETTER, but society will never be perfect. Other classes/groups of people strive for legal and social equality. We make laws to promote that. Those groups sometimes have common cause and sometimes they do not — in fact, sometimes they have competing interests.

      I think the baseline is how do people see people who identify as trans. And I think the large majority do not see a trans identity as anything but a self-defined characteristic that is no different from a religious affiliation or an identity based on personality traits. If people want to go around saying they’re the opposite sex, polite society can accommodate that, just like polite society can accommodate people saying they’re Jewish or Christian or gamers or Wiccans or any other self-described grouping. The issue is that now we have a (very small, BTW) group os people who are not just saying, “I’m trans” — they’re making EVERYONE ELSE CHANT, “Transwomen are women.” And, well, a lot of women are saying, “Nope.” A lot of men are saying, “Nope.” (And, of course, why we’re here, it seems a lot of transactivists are pushing that children and teens need to have their identity development medicalized, increasingly trapping them into a specific gender identity which may have been caused by any number of undiagnosed and untreated factors.)

      The history of women becoming the social and legal equal of men is not very long in the United States. Adult women fought for BATHROOMS AT HARVARD LAW SCHOOL FOR WOMEN in the 70s. Think about that — in the 70s. I was already in school — elementary school, but still. Within MY lifetime, women couldn’t get credit cards without their husband and even if they were accepted to Harvard Law School, when they sat for exams, there was no bathroom for them to use. My mother couldn’t compete in sports because she was female and there were none in her school because why have girls sports. Now, within three generations, my girls have no reason to compete because our school district says that natal males who identify as girls are exactly the same as my girls — when they’re not. And, now girls are being thrown back to the same position they were in for my mother’s generation and before — there’s the class for males and everyone else is out of luck.

      I guess I’ve rambled on enough. I don’t care WHY people see this happening. I don’t care if they disagree with a point here or there. I don’t care how a person is registered with a political party. What I care about is that children and teens and young adults and families caught up in this are allowed the same rights to seek treatment for THEIR OWN KIDS and be seen as having the same knowledge of their individual children as the parents who trans their kids. And, I don’t want biological men to be allowed to access the rights of biological women and girls. Full stop. I may vote differently from every person on this board. I might not. We might agree or disagree on every other issue under the sun. We may agree on this, for different reasons.

      The important thing is if we agree that parents know their kids and there’s evidence that waiting and allowing kids to explore identity and get treatment for comorbid conditions and only allow ADULTS to hormonally and surgically alter their bodies and we want to protect women and girls, as a class, due to historically unfair discrimination, then we’re good on this. And, I’m good with Trump on this. A stopped clock, is, in fact, right twice a day. If it’s the right thing, it’s the right thing. Doesn’t mean you’re not a critic of the current administration. Doesn’t mean you agree with everything he does.

      Again, perfection is the enemy of the good.

      Liked by 2 people

  6. This is a carefully chosen wedge issue, far more complex than anyone realizes. It is similar to how gay marriage was used a few election cycles ago. It is just meant to rally the conservative vote. The notion that you can discriminate againts people based on the legal medications prescribed by doctors is beyond strange. As usual the journalism is lazy and does not go beyond the surface.


  7. Trump has no authority on what’s scientific or not. He’s not a scientist or psychologist/psychiatrist. How can he judge transgender to not be a thing? He’s just setting folks up for discrimination. I was looking forward to nonbinary gender markers on documents. Gender identity being different from sex is the TRUTH. Also, the majority aren’t trans or nonbinary, so their gender identity matches their sex. It doesn’t matter how someone expresses themselves. There are butch and masculine cis women. Those folks aren’t trans by any means, no matter what they look like. Gender identity is different from expression. There are masculine trans women as well. And sexual orientation is different from gender identity AND expression. A masculine cis woman could be attracted to cishets and therefore be heterosexual, or else be a lesbian, or attracted to nonbinary people, or to anyone. There’s nothing inherently sexist about any of this. Some trans folks probably are sexist though, like anyone else could be, and should be educated.

    When I use terms like “masculine” I’m just using a stereotype to make things easier. Masculine stereotypes shouldn’t be associated with males and feminine stereotypes shouldn’t be associated with females, at least not anymore. If something feels oppressive, then it’s wrong. It goes against who we are, which is determined tremendously by our genes. That’s why oppression must be fought against, and that’s why females have fought for freedom and continue to fight. Oppressing others goes against science.


  8. Pingback: Parents petition American Academy of Pediatrics in response to policy statement on trans-identified youth | 4thWaveNow

  9. Katiesan suggested a petition in one of the comments above.

    There is one here;

    Everyone please sign this!
    I am a doctor, and the parent of a child with ROGD
    I had no idea what was going on in this arena until I researched it recently in order to help my child. I am horrified by paediatric medicalisation, and completely disagree with it.
    I suspect I am part of a silent majority of doctors who are either unaware, or are afraid to speak out publicly.

    Liked by 2 people

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s