We are petitioning the American Academy of Pediatrics to renounce its scientifically unsupported "affirmative" policy for young people with gender dysphoria.  This harmful policy is in direct conflict with the AAP constitution and bylaws, which say [1]“The American Academy of Pediatrics shall pursue specific scientific, social, and educational objectives including the following A.foster measures and conduct activities directed toward establishing and maintaining the highest quality and acceptability in the delivery of health care to infants, children, adolescents, and young adults”.

The affirmative model is presented in the AAP policy document, [2], as the only option to support young people with gender dysphoria. This is incorrect and harmful.  Not only does the article misrepresent its sources [3] to justify this scientifically unsupported policy, it also incorrectly implies that any approach besides affirmation (for instance, commonly advocated exploration and/or watchful waiting) is “conversion therapy.”  This is in spite of the long well known fact [4] that mental conditions which are very different (OCD, ASD, trauma, separation anxiety) can cause gender dysphoria, and, when resolved or taken into account, can sometimes resolve the gender dysphoria as well.  Recent research has found even more evidence in favor of exploration, not affirmation [5].   People badly harmed by affirmation, which put them on a speedy path to lifetime experimental, dangerous and off label drugs, and sometimes surgery, are starting to speak up, e.g. [6]. The AAP should base its recommendations on the science, and recommend that children, adolescents and young adults with gender dysphoria get exploration, psychological care, and accurate information, not quick affirmation of their self-diagnosed conditions.

[1]https://downloads.aap.org/AAP/PDF/Const-and-Bylaws-2020.pdf, article IV A

[2] Rafferty et al, 2018, Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents 

[3] Cantor, 2019, Transgender and Gender Diverse Children and Adolescents: Fact-Checking of AAP Policy

[4] e.g., a Campo et al, 2003, Psychiatric Comorbidity of Gender Identity Disorders: A Survey Among Dutch Psychiatrists, Bockting et al 2006, Counselling and Mental Health Care of Transgender Adults and Loved Ones

[5] Clarke and Spiliadis, 2019, ‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting with gender identity difficulties,  Evans, 2020, Freedom to think: the need for thorough assessment and treatment of gender dysphoric children, D’Angelo et al, 2020, One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria, Withers, 2020, Transgender medicalization and the attempt to evade psychological distress

[6] The Economist, Dec 12, 2021, After the Keira Bell verdict - An English ruling on transgender teens could have global repercussions