最新杏吧原创

ST. LOUIS 鈥� The world鈥檚 leading medical experts in transgender health took aim Thursday at a proposed emergency regulation that would restrict gender-affirming medical care for minors in Missouri.

Missouri Attorney General Andrew Bailey鈥檚 proposed rules are 鈥渂ased upon manipulated statistics, flawed reports, and incomplete data, and prevents the provision of medically-necessary care,鈥� read a statement from the .

The association is made up of nearly 3,000 providers and researchers who care for and study transgender and gender-diverse people across the globe in order to provide the best care.

Since its founding in 1979, the group has for the treatment of individuals with gender dysphoria as new scientific evidence becomes available. The standards are considered the best evidence-based guidelines for providers.

Bailey announced Monday he was filing , which among other things, will require an 18-month waiting period, 15 hourlong psychiatric assessment sessions and that any mental conditions are 鈥渞esolved鈥� before Missouri doctors can provide gender-affirming care to minors.

The new rules have yet to be officially filed, but it鈥檚 the first time a state鈥檚 attorney general has stepped in to limit access to gender-affirming care.

鈥淲e need to get creative and use every legal recourse we have available to us to stand up and protect kids from this kind of predatory left-wing ideology masquerading as medicine,鈥� Bailey, a Republican, said Wednesday on Twitter.

Bailey last month called for a moratorium on the use of puberty blockers and hormone therapy at Washington University Transgender Center at 最新杏吧原创 Children鈥檚 Hospital while his office investigates allegations by former case manager Jamie Reed that patients there were rushed into treatments and parents were not properly informed.

University and hospital leaders, however, rejected that call. 鈥淲e cannot institute a moratorium that would deny critical, standards-based care to current and new patients,鈥� the heads of Washington University and BJC HealthCare said in a letter to Bailey. 最新杏吧原创 Children鈥檚 Hospital is a BJC facility.

Republican-backed legislation barring doctors from providing puberty blockers or hormones to minors for gender transition also continues to make its way through the Missouri Legislature.

In announcing his plans to file an emergency regulation, Bailey made several arguments that caught the attention of WPATH as 鈥渓acking scientific grounding.鈥�

Bailey wrote that because gender transition interventions are 鈥渆xperimental,鈥� they are covered by Missouri law governing unfair, deceptive and unconscionable business practices.

鈥淕ender-affirming interventions are based on decades of clinical experience and research and are not considered experimental,鈥� the expert group said. 鈥淕ender affirming hormone therapy is a component of widely accepted medically-necessary care for TGD (transgender and gender diverse) people.鈥�

In addition to WPATH, the global Endocrine Society and America鈥檚 largest medical associations 鈥� including the American Medical Association, the American College of Physicians, the American Academy of Pediatrics and the American Psychiatric Association 鈥� all support gender-affirming as medically-necessary care, the group also pointed out.

Required disclosures

Experts with WPATH took issue with a list of disclosures that Bailey says patients seeking transgender care must be told.

They include informing patients that using puberty blocker drugs or cross-sex hormones to treat gender dysphoria is experimental and is not approved by the Food and Drug Administration; and the FDA has issued a warning that puberty blockers can lead to brain swelling and blindness.

In its critique, WPATH states that sex hormones estrogen and testosterone were approved decades ago and are often used 鈥渙ff-label鈥� to treat a myriad of hormone conditions. Using approved drugs 鈥渙ff-label鈥� for different conditions is not uncommon or illegal.

The FDA approved puberty blockers 30 years ago to treat children with very early puberty. In July 2022, the FDA about the drugs after identifying six cases of brain swelling: Five were using the drugs to stop early puberty, and one was using for transgender care. All were assigned female at birth.

Symptoms had resolved or were resolving in four of the cases during the FDA鈥檚 review, and the FDA concluded that the number of cases was too small to draw conclusions.

Another one of Bailey鈥檚 required disclosures is that the risk of puberty blockers and hormone therapy in minors outweigh the possible benefits. WPATH, however, says Sweden recommended restraint in use of the medications, not a ban, and that the declaration was not backed up by any studies.

Patients are also to be told about the Endocrine Society鈥檚 finding that about 85% of children experiencing gender dysphoria before puberty no longer experienced dysphoria in adolescence.

However, puberty blockers are not to be used to treat gender dysphoria until the patient begins puberty, experts say.

In published by the American Academy of Pediatrics, Princeton researchers found that five years after their initial social transition, which involves changes such as different pronouns or clothes, nearly 98% of gender divergent youth continued to identify as transgender or non-binary.

Lastly, patients are to be told about study that found an individual whose friend identifies as transgender is 鈥渕ore than 70 times鈥� as likely to also identify as transgender, suggesting that social factors cause some to incorrectly believe they are transgender.

Experts say the skewed 2018 study was based on surveys of parents, some who opposed their children鈥檚 gender identities. A year later, author Lisa Littman to the study stating that it does not include data from the adolescents or clinicians and does not validate the idea of social contagion.

The WPATH group accused Bailey of stringing together misinformation in order to prohibit health care that is safe.

鈥淎ttorney General Bailey鈥檚 claims were either taken out of context, cherry-picked, or from unverified sources,鈥� its statement read.

In addition to prohibiting providers from treating patients for gender dysphoria until the patients are cured of other mental health conditions and have undergone at least 18 months of assessments, Bailey鈥檚 regulations would require providers to annually ensure that patients are not experiencing social contagion and adopt procedures to track adverse effects for 15 years.

These requirements are not in agreement with best practices, said Shane Diamond, spokesman for WPATH.

When Bailey was asked by a reporter how he developed the medical guidelines for providers, a spokeswoman for the attorney general鈥檚 office, Madeline Sieren, responded by email: 鈥淭he regulation is based on an assessment of the scientific evidence.鈥�

Sieren did not respond to requests for further details.

鈥楶owerful untruth鈥�

Reed, the whistleblower who worked for four years at Washington University鈥檚 pediatric transgender center, alleged in a first-person account and , a new online publication, that every patient 鈥渨ho came through the door鈥� received cross-sex hormones, often after just one psychiatric assessment and despite other mental health conditions.

Reed called for the clinic, one of two in Missouri, to be shut down.

Reed and her attorneys with the Child and Parental Rights Campaign, said they had no comment about Bailey鈥檚 planned regulations.

Julie Flory, vice chancellor of marketing and communications for Washington U., said the university will review Bailey鈥檚 regulation once it is filed.

鈥淲e take the care and safety of our patients very seriously,鈥� Flory said in an email. 鈥淥ur focus remains on our commitment to providing compassionate, family-centered care to all of the patients and families we serve.鈥�

Leaders from providing treatment for minors in the Kansas City region, that the hospital was also waiting for the attorney general鈥檚 rules to become official.

鈥淲e are monitoring the proposed legislation, and now the emergency regulation, closely and continue to be dedicated to providing the best evidenced-informed care,鈥� a hospital statement said.

最新杏吧原创-area parents with transgender children have sharply criticized Bailey鈥檚 action.

Jennifer Goldring of 最新杏吧原创 County, the mother of a 16-year-old son on testosterone, said she is unsure how the order would affect her son.

鈥淚鈥檓 terrified of what this means for my child and his mental health if he cannot get the gender-affirming care he needs,鈥� she said.

is a clinical professor of psychiatry at Columbia University and past president of the who served at editor of the gender dysphoria chapter in American Psychiatric Association鈥檚 latest diagnostic manual.

Drescher said gender dysphoria is complicated with a wide range of patient experiences that require individualized treatments. He tried best to boil it down to two kinds of patients: those who will benefit from medical treatment and those who don鈥檛.

鈥淲hat these kinds of laws and regulations are trying to do is they are trying to prevent some child from making a mistake, who will regret it 鈥� which is an admirable goal. But they are doing it at the expense of the child who will benefit from this treatment,鈥� Drescher said.

Drescher said providers should not be routinely prescribing medications after one or two visits. 鈥淏ut that is not a reason to ban treatment for those getting more comprehensive evaluations,鈥� he said. 鈥淚f there are individual practitioners who are doing that, then go after the individual practitioners, not the process.鈥�

He said politicians have also taken reports of big increases in the numbers of adolescent girls identifying as boys as reason to ban care rather than improve it.

Republican-led state Legislatures have made limiting gender-affirming medical care a top priority. Across the country this year, about a dozen states have succeeded in passing restrictive laws, and more are expected.

鈥淚f this were a normal situation, what would we do if there鈥檚 an explosion of cases? We would fund more research to do more studies about how can we best help all these cases?鈥� Drescher said. 鈥淏ut, that鈥檚 not happening here. Because there are more cases coming, people are saying stop all the treatments. If that鈥檚 not politics, what is it?鈥�

Updated at 2 p.m.