Trans ideology is distorting the training of America’s doctors

GRAMENDER DYSPHORIA, the often agonizing feeling that one has been born into the wrong body, is listed in the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders.” So Katherine (not her real name) was surprised, in her first week at Louisiana State University School of Medicine, when a professor told a class that gender dysphoria was not a disease. mental. She suggested that gender identity ideology, which holds that transgender women are women and trans men are men, had influenced some of those who were training her to be a doctor.

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More tests followed. An endocrinologist told a class that women taking testosterone had a similar risk of heart attack as men (they have a much higher risk). Debate on all of this was apparently off limits. How has trans ideology reached medical schools?

Professional bodies, including the American Academy of Pediatrics, have endorsed “gender-affirmative” care, which accepts patients’ self-diagnosis that they are trans. This may mean prescribing puberty blockers for children as young as nine. Trans medicine is not a core part of medical school curricula. But one academic pediatrician (who did not want her name, institution or state to appear in this story) says that all medical students understand that they are expected to follow the affirmation model “without criticism or questioning.” For most doctors, that will mean referring a patient to a gender clinic, some of which prescribe blockers or cross-sex hormones on the first visit. “We treat infections with antibiotics, no questions asked, that’s exactly how it is,” she says.

Affirmative care has done irreversible damage to the bodies of some young people. This has become especially clear from the experience of “people in detransition” who regret taking hormones or having their breasts or genitalia removed. Puberty blockers also prevent bones from developing properly; when combined with cross-sex hormones, they can lead to infertility and the inability to have an orgasm. A 26-year-old medical school student in Florida who plans to become a pediatrician is shocked by what she hasn’t been taught about these treatments. “With other diseases and treatments, we are taught so deeply about all the possible side effects,” she says.

Medical school scholars suggest two reasons for all this. One (reflected in the fact that no one wanted their names published) is fear. Some trans rights activists intimidate anyone who raises their concerns publicly. The other is ignorance. A pediatrician who teaches at a medical school in Florida says that once doctors have finished their training, many pay little attention to new medical research and rely on the media for information. In the United States there has been little coverage of the dangers of blockers or the problems of detransitioners.

Last year, Marci Bowers, a surgeon (and trans woman) who performs vaginoplasties and phalloplasties, said she no longer approved of the use of puberty blockers because they left surgeons with too little genital material to work with and caused a loss of sexual function. This, unusually, seemed to surprise some doctors at the gender clinic. Ignoring the difference between biological sex and gender in medical school has other risks. Several diseases present differently in men and women or are more common in one sex than the other. A doctor who treats a trans man, let’s say, like a man might be missing something important.

Katherine, the student from Louisiana, worries about the effects on female patients. As a black woman, she is well aware that “when doctors have an implicit bias against black people, it leads to poor care.” Gender identity ideology, with the use of terms such as “bodies with vaginas” in medical journals, has “increased prejudice against women by normalizing dehumanized language and fostering hatred of women who assert their boundaries” . She worries that doctors who have absorbed these insights during training are less likely to provide high-quality care to patients.

She is also concerned that gender ideology is impeding the development of critical judgment in medical students. “It’s a problem,” he says, “when doctors start to believe that they can just ignore medical evidence and scientific facts that they don’t like.”

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This article appeared in the US section of the print edition under the headline “Identity Issues.”

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