Doctor: Time for transgender treatment industry to “follow the science”

Dr. Patrick Lappert

Dr. Patrick Lappert

This is an opinion column

I read, with great alarm, the breathless opinion piece by Dr. Ladinsky which vilifies the Vulnerable Child Compassion and Protection Act (SB-10). This legislation aims to protect vulnerable children from the transgender treatment industry that is prescribing puberty blockers, wrong-sex hormones, and even mutilating breast surgery to children.

In her opinion piece, Dr. Ladisnky warns that she would be “criminalized for providing care” to gender confused children. She characterizes the bill as some medieval work of scientifically unenlightened Alabama politicians who have never even met a “transgender youth”. She claims that government has no business regulating the behavior of doctors.

I am a reconstructive surgeon. I served in that capacity in the US Navy for 24 years. I have been in practice in Alabama for 16 years. I have been a physician for 40 years. I have met, and continue to serve persons who are self identified as “transgender”, and patients who regret the decision and are seeking a way to “go back” to the sex presentation they were born with.

Doctor Ladinsky claims that science is on the side of the transgender treatment industry. It is not. I read the scientific literature on this subject all day long. Virtually all of it is comprised of the lowest form of scientific evidence; small studies, with few patients, followed for short periods, all of them biased by self-selection (the patients who have committed suicide don’t come back to answer their vague questionnaires about their sense of happiness). This is NOT evidence based care. It is the least reliable form of evidence, but the transgender treatment industry has been satisfied with it for fifty years now, and don’t seem interested in answering the most basic questions about the condition.

Doctor Ladinsky doesn’t seem to care that there has been an explosion in this diagnosis in the last five years. It used to be that gender confusion was only 0.2% of children, and almost always very young boys. Suddenly there has been a 5,000% increase in the diagnosis, and now it is 80% females in adolescence and young adulthood. How could that possibly be biologically caused? Was there a mass mutation event? Is there something in the drinking water? The transgender industry doesn’t seem to care to even ask the question: “Why is there an epidemic of gender confused children”?

The countries that have been offering gender services to children longer than the US are all abandoning this scientifically unsupported care. Just this year, Sweden, after examining the best long term population data found that children are not improved, and has abandoned puberty blockers, and cross-sex hormones for children. Likewise in Finland: no puberty blockers or cross sex hormones. Their guidelines emphasize that psychological support, and family therapy will be (as it used to be) the first line of care.

The UK’s Tavistock Portman clinic, which was the sole provider of these drugs to gender confused children are no longer at liberty to give puberty blockers and cross-sex hormones to children under 16 after a court ruling in a lawsuit brought by a gender confused woman who was given these drugs, and had her breast surgically removed even before she reached adulthood.

It is important when reading Dr. Ladinsky’s opinion piece, that she begins with her most compelling argument, which is no argument at all. She begins with a personal anecdote, which in the world of medicine is the least reliable evidence, second only to a “professional opinion”. Her anecdote is about a suicidal child who needs care. I couldn’t agree with her more, that a child who has attempted suicide three times need love and professional care. What they don’t need is permanently life altering drugs and surgery.

A person who is depressed and suicidal is so bad at making decisions that they are considered incompetent to give consent for medical care. Add to that the fact that the person making the diagnosis isn’t Dr. Ladinsky, it is an anxious, confused, suicidal child.

That doesn’t change with time. Ultimately the whole long road from social transition, to puberty blockers, to cross-sex hormones, to permanently sterilizing surgical mutilation begins with a diagnosis that was made by a confused child. Dr. Ladinsky has no medical test to prove or disprove the diagnosis, and yet she claims her care is “evidence based.”

Is there a place for Alabama law in this issue. Emphatically yes. We already have such laws protecting children from the harmful effects of sex hormones. If a parent brought their son to Dr. Ladinsky and said, he is suicidal because he “has always known on the inside that he is supposed to be an offensive lineman for Alabama, but at age 16 he is skinny and weak, the law prevents Dr. Ladinsky from prescribing anabolic steroids and testosterone. This is no different. If she were making a living prescribing anabolic steroids to high school athletes, she should lose her white lab coat and her stethoscope.

Alabama legislators have a duty to protect this vulnerable population of gender confused children. Psychological care, family therapy, and at times the use of certain medications has proven effectiveness. Over 80% of children treated this way abandon their cross-sex idea of themselves by late adolescence. However, if you let them fall into the hands of the transgender treatment industry, virtually 100% will continue to suffer from gender dysphoria, and will ultimately have the same high risk of self-harm, including alcohol abuse, drug abuse, psychiatric hospitalization, and suicide. This is no longer in doubt. This is why Sweden, Finland, and the UK have abandoned the use of puberty blockers, cross-sex hormones and surgery in gender confused children.

It is time for the Alabama legislature to pass SB-10. It is time for the transgender treatment industry to “follow the science.”

Patrick W. Lappert, MD, of Decatur, is a retired Capt. with the U.S. Navy and a Decatur, and is Board Certified in General Surgery (1992) and Board Certified in Plastic Surgery (1997) Recertified (2008).

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