June 27, 2013

Three Questions for the American Academy of Pediatrics

Regarding your June 24 policy statement on “Sexual Minority Youth”:

1. You state that a teen who questions if he is male or female, or who wants his genitalia removed, is “normal, just different.”

Given the physical differences between male and female are more substantial than between different races, if an African American teen is convinced she is really Caucasian, is she also “normal, just different?” Should her pediatrician affirm her belief, and support her wish for facial surgery and skin bleaching?

2. If my son thinks he’s a girl, you recommend I find a therapist who will respect and affirm his belief.

But if my son is attracted to boys, and his urges feel foreign and distressing, you advise me to find a therapist who will tell him “this is who you are, accept it.”

Honestly, does that make sense?

3. You are calling on all pediatricians to fight homophobia and heterosexism. Per the FBI, the number of hate crimes motivated by sexual orientation bias is similar to those motivated by religious bias.

Will the AAP be calling on its members to fight society’s irrational hatred of God-fearing people?

21 comments

  1. Jacki Maki - reply

    Would love to read the article however, the link isn’t good “page not found” is all that’s available. Attempted to find and cannot. Please help. Thanks for all you do for girls and womens health.
    A fan.
    Jacki

  2. Pingback: Bruce Llama Grossman asks the questions | Bruce Llama

  3. Brad - reply

    You’re [expletive deleted] crazy! We’re living in the 21st Century, not 1950!

  4. Mary Reichard - reply

    I believe we are in the age of irrationality, where people believe equality in treatment equals equality in outcome. This requires us to suspend facts before our eyes and make a leap of faith that the social engineers guiding us know better than anyone else.
    Dr. Grossman, never give up. You have the facts, you have to knowledge, and more importantly, you have the wisdom we need.

  5. MiriamGrossman - reply

    Brad, I am happy to engage in discussion with you if you can : 1) refrain from obscenities, and 2) address the substance of my argument.

  6. Janie - reply

    Dr. Grossman, Thanks for all you are doing to save our children. Please keep posting and writing! As a parent of four, we need the truth and we are not getting it from the culture.

  7. Jo - reply

    Agreed with Mary Reichard. Everything these days is a mere illusion, allowing people to make the “reality” suit them. I write a blog which seeks to dispel these disillusions. NGOs which talk about equality in a way which sides particular groups cannot be trusted.

  8. trhampson - reply

    Have you written a response the the AAP’s revised policy? If so, where is it posted?

    Keep up your good work.

    • MiriamGrossman - reply

      No, I haven’t, no time! Thanks for your support.

  9. Dania Ng - reply

    It would be interesting to know who is/was on this organization’s committee responsible for developing the policy. In the case of the APA, we know that the equivalent group consisted mainly of homosexualists. In the case of the American Psych. Association, it is the same, with a blank refusal to allow any differing interests to be represented in policy-making processes. It is important to expose the systematic bias, both in the peak professional organizations, and the ‘science’ being manufactured by invested (so-called) scholars and researchers.

    Thank you for your principled and responsible stand, Dr Grossman

  10. Maureen - reply

    Dear Dr. Grossman,

    You are a Godsend.

    Maureen

  11. A Concerned Parent and Community Leader - reply

    I don’t know where to place this so I figured I would just drop this here. I am someone who is trying to figure out what he feels on many of the discussions you address but I do have some things that I was hoping could be clarified.

    On the argument that earlier sex means fewer chances for health related issues: That makes a lot of sense! However I guess i’m torn because– Not going outside at all reduces your chances of getting hit by lightning and not driving means no car accidents. This is common sense but not very practical in these instances. There are lots of things we can do to protect our kids by suggesting that they don’t engage in any behaviors with risks. I wonder if you would similarly suggest raising the driving age to 30 because research shows that young adults and teens cause most accidents even when accounting for years of experience. This particular line of reasoning is a good one but the line seems arbitrary so I guess my question is if I should embrace bubble-boy parenting.

    It would seem to me that given that life comes with risks one can simply educate on how to be safe and then, instead of fear mongering, espouse the benefits that can be had with the activities in question (driving, skydiving, making origami, sex, bike riding) when safety protocol is observed. If you take issue with my assertion that there exist benefits then I wonder if that is simply a product of ideology or is backed by a study that I missed when I reviewed your materials. Please help me. A study showing that sex barring any sexual violence (which can occur whether or not someone wishes to abstain) or disease is dangerous would go a long way to helping me feel comfortable about your message. :-)

    On the subject of references I am interested in the studies about “teenage cervix.” I think you are probably looking at articles like Kahn et al.,2002 J Pediatrics.

    My question is: where else can i look for more info? This doesn’t make a great argument because the authors say that much of the effect could have been explained by the fact that shorter ‘Menarche-1st Intercourse intervals’ might just be confounded by earlier sex initiation. Given that the population in question received sex-ed during the era of “delay and abstain” sex-education the fact that they started earlier and were less protected doesn’t support the idea that such education works. What studies better support this biological idea without confounds of an antiquated education system?

    There is to my (admittedly limited) knowledge no research showing exclusively the biological permeability. To the contrary what I have read is that: All of the data about antimicrobial properties of the mucosal secretions seem to point towards the largest delta being a product of where one is in their menstrual cycle REGARDLESS of age. I thought it was known that secretions are maximal at the greatest reproductive window which (as you have so greatly explain as a reason for abstinence) falls in the teenage years. So I guess the risks of pregnancy are higher but given that the body is expecting sex during that period it would follow that it would likely be most protected against disease then as well.

    Even considering the ideas of immature columnar and metaplastic
    cells: what do you think of the idea that, theoretically, tests for levels of progesterone and a quick swab and microscopy to ensure epithelial cell maturity should be enough to give the go ahead to our daughters. I guess you’d probably be ok with that. Seems weird but a quick check up and some good talk about the risks and how to be safe can make sex for adolescents fine again. If I understand your position correctly that is what you are advocating for! Any insight or guidance would be much appreciated. Until then, I’ll make sure that the young men and women of my community have the science and know how to safely have sex without stress or guilt.

    Thanks Dr. Grossman :)

  12. Zoe Brain - reply

    It seems to me that we’re talking past each other.
    You see the issue as one of morality, and religious belief.
    I see it as one of anatomy,of observable fact.
    Moreover, you conflate two distinct concepts – gender identity and sexual orientation. Yet Trans lesbians and Trans gays exist.

    Examples that may help you understand where I’m coming from:

    A sex difference in the human brain and its relation to transsexuality. by Zhou et al Nature (1995) 378:68–70.
    Our study is the first to show a female brain structure in genetically male transsexuals and supports the hypothesis that gender identity develops as a result of an interaction between the developing brain and sex hormones

    Sexual Hormones and the Brain: An Essential Alliance for Sexual Identity and Sexual Orientation Garcia-Falgueras A, Swaab DF Endocr Dev. 2010;17:22-35
    The fetal brain develops during the intrauterine period in the male direction through a direct action of testosterone on the developing nerve cells, or in the female direction through the absence of this hormone surge. In this way, our gender identity (the conviction of belonging to the male or female gender) and sexual orientation are programmed or organized into our brain structures when we are still in the womb. However, since sexual differentiation of the genitals takes place in the first two months of pregnancy and sexual differentiation of the brain starts in the second half of pregnancy, these two processes can be influenced independently, which may result in extreme cases in trans-sexuality. This also means that in the event of ambiguous sex at birth, the degree of masculinization of the genitals may not reflect the degree of masculinization of the brain. There is no indication that social environment after birth has an effect on gender identity or sexual orientation.

  13. Zoe Brain - reply

    A more concrete example – because my area is not sexual orientation, but gender identity especially as it relates to Intersex people.

    http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/cth/FamCA/2010/237.html

    From your own medical, moral and religious viewpoint – was the judicial decision correct? Why or why not? Was the reasoning correct? What other matters should have been taken into consideration, and what matters should have been omitted?

  14. Amanda - reply

    The logic in #3 is distressingly flawed. The policy statement is addressing sexual identity, so it addresses the violence motivated by homophobia. Should we ignore one type of violence just because you brought up another? Forget about homophobia because religious persecution also exists? That makes zero sense.

    Religious bias, by the way, isn’t against “God-fearing people.” 83% of the US’ population is Christian. Politicians have to profess some form of Judeo-Christian faith just to get elected in this country. “Society” doesn’t hate religious people; society IS religious people.

  15. Shawn - reply

    Dr. Grossman,
    I am extremely bothered by this post. Mostly because it is a post similar to one my mother saw shortly after I informed her that I was having extreme discomfort and distress about my physical sex. As a result she did everything she possibly could to diswade me from visiting with an LCPC to get the mental and emotional support I needed. Instead she sent me to several different counselors who did substancially more harm that good. I was frequently suicidal for years; I struggled with depression and anxiety, I was having problems maintaining friendships and I was constantly under performing in school. It wasn’t until I saw a counselor who actually followed the standards of care you seem to think are so damaging, that my grades improved, my friendships improved, I got of all the anti depressants and anti anxiety medications, and I quit attempting suicide.
    You base a lot of your arguments on science. I’m wondering where the peer reviewed non biased studies are that back up these arguments. There are a number that show there are clear anatomical differences in the brains between men and women and that people that identified as transgender (but had not undergone any sort of transition) had brains that were “anatomically identical and indistinguishable” from the opposite of their physical sex.
    I would offer my own question, “Is it better to have a child that is the opposite sex or a child that is dead?”
    For me transitioning was a matter of life and death. Please listen to your children and carefully consider what is truly in their best interest.

  16. Leticia - reply

    Society does not accept strange people – that is the premisse of this article.

    If your child is strange, you and his or hers medical professionals should urge them to try and be normal.

    Are you for the “gay cure”?

    In my strange point of view, badgering strange people to conform leads to further pain and distress.

    I have never met a same sex attracted person that never felt it would be easier to be hetero. If your therapist starts telling you the same, there is a good chance that this person will remain “in the closet” for a long time and suffer more, not less.

    Should we try and change society into a more accepting place or should we beat our children into conforming?

  17. Mrs. Alison Beil, B.Ed. CCC - reply

    Dr. Grossman – I have read this blog and the comments and think you should reply to Zoe Brain. I suggest the following: The example from Court in Australia is a real one, and a tragic one, given that “Sally’s” male chromosome identity was not determined at the time of her birth. Had that been the case the influences that have caused her to believe herself to be a “girl” abnormally developing testes and a deepened voice at puberty could have been very different – instead of wanting to accept that she must be a woman without a uterus, she might have been enabled to develop more normally as a man. However, respecting her will at age 14 to remain as a girl and develop as normally as possible as a woman, does not seem an immoral judgement – it is perhaps the best that can be done for her given that the error made at the time of her birth can not be changed – she has been identified and does identify as a female for 14 years. Hopefully, improved medical research-practitioner science now will help prevent more such tragedies. This is not about religion – there have always been people mis-identified. Castration is not new – nor is FGM and various forms of self-mutilation – such cultural practices have been done throughout history. The claim, however, in the abstract written by Garcia-Falgueras and Swaab – that “there is no indication that social environment after birth has an effect on sexual orientation (and thus also on gender identity) is ludicrous. It obviously does – or people would not become orientated to think of themselves as as a sex different from their chromosomes, or sexually attracted to anyone. The opinions in their abstract are not conclusive – they merely state an agreed belief that there are two processes – a genetic one and a brain function one. Obviously there are many processes that influence both male and female development by many factors that “may” result in extreme cases of gender dysphoria. Have you read the full article for facts? I really doubt any actual patient exists that has male chromosomes and also a fully developed “female” brain structure at birth. I think it’s highly unlikely that all MD’s would agree with those two. Medical research is obviously on-going, particularly in regard to intersex cases and the factors that are affecting those conditions. I suggest you also read this one – The transsexual brain – A review of findings on the neural basis of transsexualism.
    Smith ES1, Junger J2, Derntl B3, Habel U2.

    Ethical medical doctors are trying to establish standards for research so we can all deem scientific findings valid – they also have a duty as practitioners to not mislead the public with dis-information. But some, less ethical ones, evidently already have for years – in part by producing, marketing, and prescribing hormones for birth control as abortifacients – some doctors have capitalized excessively for themselves while causing harm to others and misleading the public generally, even adding to the contamination of drinking water. Other ways are by following whatever political and economic agenda they think will be more expedient for themselves without having any real regard for their duty to future generations.

  18. Mrs. Alison Beil, B.Ed. CCC - reply

    Evidently there are also some important considerations in regard to oxytocin and it’s effect on brain function in male and female brains and thus on human relationships. The so-called “love hormone” or “cuddle hormone” has long been known scientifically – it tends to make socially inhibited people more outgoing and empathetic, when they think and feel that they are receiving empathy from someone. Obstetricians have long found it useful to prescribe to induce labour in over-due pregnant women. Now the same hormone is being considered and tested for various psychiatric diagnoses – like addictions to nicotine and other drugs, and for treatment of autism. Oxytocin has been found to be naturally produced in women who enjoy healthy monogamous sexual relationship and also triggered among those who gain the assistance of other empathic women with their pregnancies, emotional support to help relax and lactate and nurse their babies. Some women evidently don’t get that same sort of empathic assistance from male doctors – and many suffer excessively from postpartum depression – their babies also suffer.

  19. Mrs. Alison Beil, B.Ed. CCC - reply

    I have now read on Wikipedia, more about John Money and his evidently dishonest and harmful practice of “psychology” as alleged by both the Canadian identical twins that he abused as research subjects. I think it’s obvious also from what “Shawn” posted that what is pretended to some dis-satisfied people to be “medical science” evidently is not well supported to them, even though they temporarily may be influenced by anti-depressants to feel better – those feelings can also change when they experience longitudinally other side effects of medication. The claims of dis-information misleading David Reimer and his twin brother Brian were made by themselves. Each evidently lived to tell his tragic story of victimization – that Money coerced them to act in sexually offensive ways with each other that they remembered – and that those claims eventually persuaded the parents to accept David’s own choice for his male identity and to stop insisting he and his brother continue to be influenced by John Money. I see no reason to think that was two cases of “false memory syndrome” as is apparently contended by Money’s defenders. David was in fact subjected in early childhood to a botched circumcision by cauterization that a urologist then did not attempt to do also to his twin brother. He was then also unsuccessfully urged throughout much of his childhood to pretend that he was not originally named Bruce – to try to “act” at school as if he was a girl named Brenda – and he was not told immediately that he’d also suffered other surgery and mis-treatment with hormones, only because the authorities over him as a child did not want to admit that they had opted for unnecessary circumcision that was harmful. There was no question in that case about the boys chromosomes. Still instead of being honest and telling him that he’d suffered a botched circumcision and then also further transgender surgery and hormone treatments he was forced to feel also sexually abused by John Money also using his twin brother to do that abuse. His twin brother Brian, evidently also was psychologically and sexual abused by Money – then finally diagnosed as schizophrenic by a psychiatrist – and predeceased David. Those are both certainly more tragic cases of errant belief in “gender identity” presumed able to be a better alternative than biological chromosome normal development even with a tragic loss of penile function. That is certainly different than that of “Sally” in Australia if one can trust the Court’s report of that case being one where the child truly felt and thought of her identity as being female from infancy. The twin boys obviously knew of their identical twin-ness, their same sex identities and yet were both subjected to harmful dis-information by their parents, and that psychotic psychologist. The adults in trust positions above those children evidently attempted to capitalize more for themselves than make any sacrifices or apologies when they should have. It seems they never even respected what a more ethical family doctor, paediatrician or psychiatrist could have offered to assist their young family. Had the parents also not been so errantly dis-informed by John Money, perhaps they would have been less inclined to lie and more inclined to seek better medical consultation. They certainly also had negative influence on their children.

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