Dr Jason Rafferty, a Pediatrics Specialist at the disconcertingly named Thundermist Health Center in Woonsocket, Rhode Island in the US, has attracted a one-star review:
My child described him as ‘weird’ and ‘creepy’ after he repeatedly grilled her about her gender identity. She said she didn’t identify as anything, so they put ‘genderqueer’ on her medical records even though she identifies as a lesbian female. I didn’t even authorize this doctor to talk to my doctor; he just appeared at her regularly scheduled med check. (October 2020, by ‘Laura’.)
He is also the author of a Policy Statement put out by the American Academy of Pediatrics (AAP) in 2018, modestly titled Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents, in which we find the following definitions (paraphrased):
‘Sex’ or ‘natal gender’ is a label, generally ‘male’ or ‘female’, that is typically assigned at birth on the basis of genetic and anatomic characteristics.
‘Gender identity’ is a person’s deep internal sense of being male, female, a combination of both, somewhere in between, or neither, which result from a multifaceted interaction of biological traits, developmental influences, and environmental conditions.
Biological traits, developmental influences, and environmental conditions cover just about everything, but this means that the ‘cause’ of gender identity, and by extension the cause of gender diversity or transgenderism or whatever you like to call it, is unknown. Incidentally, I wonder what biological traits he is referring to.
Ideology of scientific hypothesis?
People who need a simple, not to say dumbed-down, approach to the concepts of sex and gender are referred to a comic book-style creation, The Gender Book by Mel Reiff Hill and two other people, of which one reviewer on Amazon says: ‘The premise that everyone has a gender identity is a belief as part of an ideology, not a scientific hypothesis.’
Nonetheless, the Policy Statement seems to be based on the assumption that transgenderism and gender diversity are entities that exist in nature rather than abstractions thought up by the writers of scholarly papers. This is in spite of the definition that ‘Gender identity is one’s deep internal sense (the words ‘deep’ and ‘internal’ are redundant) of who one is.’ In other words, it’s a feeling.
Dr Rafferty also discusses the ‘Gender-affirmative care model’. This amounts to agreeing that a young person’s gender is whatever he or she says it is. People may have opinions and feelings about all sorts of things, but I can see no reason why a doctor should accept someone’s subjective view of themselves as a medical diagnosis in the absence of any objective criteria.
Annual check-up industry
America is a country that seems obsessed with annual check-ups. For example, in the AAP’s Guidelines for Health Supervision of Infants, Children and Adolescents there is a section on ‘Early Adolescence Visits (11 through 14 years)’ where they recommend, for females: ‘Assess breast [sic] by inspection or palpation.’ The female, being expected to expose her breast or breasts for assessment by a doctor’s gaze or touch, is unlikely to perceive this as anything other than embarrassing or even humiliating.
As a further example of intrusive recommendations, here is a quote from another AAP publication, Gynecologic Examination for Adolescents in the Pediatric Office Setting:
At a minimum, examination of the external genitalia should be included as part of the annual comprehensive physical examination of children and adolescents of all ages.
In my unhumble opinion, in the absence of symptoms or concerns related to the external genitalia, this is utterly without justification.
Similarly, and apart from the question of whether a healthy child needs a regular medical check at all, seeking out gender identity problems is reminiscent of looking for reds under the bed or instances of racism by the race-relations industry in Britain. Thus, we are informed in the Policy Statement that:
The best way to approach gender with patients is to inquire directly and nonjudgmentally about their experience and feelings.
As indicated above, this approach was not appreciated by at least one parent and her child.
Furthermore, the Policy Statement shows confusion about transgenderism because on the one hand it says:
Transgender identities and diverse gender expressions do not constitute a mental disorder…variations in gender identity and expression are normal aspects of human diversity.
And on the other hand:
Pediatric providers have an essential role in assessing gender concerns and providing evidence-based information to assist youth and families in medical decision making...Many medical interventions can be offered to youth who identify as transgender and their families.
If medical decision making is needed and many medical interventions can be offered to youth in this situation then presumably we are dealing with a mental disorder or diagnosis of some sort.
Reality or fantasy?
Let us take a short section from the middle of the paper about parents’ concerns when their child ‘comes out’ as transgender:
One model suggests that the process resembles grieving, wherein the family separates from their expectations for their child to embrace a new reality. (Emphasis added.)
Earlier, gender is defined as a feeling; now the writer says it’s a reality. If he were to say something like ‘the reality of their child’s new perception of himself (or herself)’ this might make sense, and then he could merely say ‘The child’s new perception of himself (or herself).’ But clarity of expression is not something about which the author of the Policy Statement is overly concerned. For example, we are also told:
The need for more formal training…often leaves providers feeling ill-equipped.
Does this mean that providers feel ill-equipped because there is insufficient formal training, so more of it is required, or that the training they do receive is too informal and it should be presented in a more formal way? In any case, what kind of training does he mean? Is it to acquire expertise in the use of puberty blockers to disrupt the normal changes of puberty in a physically healthy young person? If a doctor were to do this he or she would be endorsing a falsehood and colluding with a child’s fantasy.
We are also told that one problem with transgenderism is that:
Adolescents and adults who identify as transgender have high rates of depression, anxiety, eating disorders, self-harm, and suicide.
However, we are reassured:
There is no evidence that risk for mental illness is inherently attributable to one’s identity as transgender or gender diverse.
Now we get to the bit, as noted by the Amazon reviewer, indicating that gender identity is part of an ideology:
Rather, the risk for mental illness is believed to be multifactorial, stemming from an internal conflict between one’s appearance and identity, limited availability of mental health services, low access to health care providers with expertise in caring for youth who identify as transgender, discrimination, stigma, and social rejection.
So the risk for mental illness is, after all, due to the conflict (again, the word ‘internal’ is redundant) of gender confusion which should be taken at its face value and regarded as a newly discovered disease to which society needs to adapt and for which the emotional and physical health needs should be provided.
Not everyone, however, is carried away by this idea. The Attorney General of Texas has declared that so-called sex change procedures and the use of puberty blockers are child abuse. So they are, but I would go further: gender dysphoria is a societal mania.
A similar view is expressed by Dr Quentin Van Meter in his talk, The Terrible Fraud of Transgender Medicine.
Postscript: GIDS should be closed down
The gender identity development service (GIDS) run by the Tavistock and Portman NHS Foundation Trust can seriously damage children; it should be closed down.
So-called gender dysphoria is likely to be an expression of distress experienced by young people with histories of childhood trauma who may also suffer depression, anxiety, eating disorders, and self harm. Therefore, it is these underlying problems which need assessment and treatment – not the fantasy of gender dysphoria that a child may present as the source of his or her unhappiness.
And how much does it cost the NHS, that is, the taxpayer, to run GIDS? A Freedom of Information request relating to the last five years provided the following figures:
2017/18 – £5.5m
2018/19 – £5.7m
2019/20 – £8.0m
2020/21 – £8.3m
2021/22 – £8.3m
This money would better be used for Child and Adolescent Mental Health Services in Britain’s NHS for which the current waiting times are far too long.
GIDS will be closed down
The British Medical Journal (20 August 2022) reported that, not before time, GIDS is to be closed down and NHS England might be sued for the harm that has resulted to the children and adolescents treated with puberty blockers and cross-sex hormones, to say nothing of irreversible surgery.
A spokesman for the litigation firm involved said:
Children and young adolescents were rushed into treatment without the appropriate therapy and involvement of the right clinicians, meaning that they were misdiagnosed and started on a treatment pathway that was not right for them. [They] have suffered life changing…effects of the treatment they received which has resulted in long term physical and psychological consequences.
The BMJ article comments: ‘Children under the age of 16 with gender dysphoria may be given puberty blockers to stop them entering puberty.’ (My emphasis.)
This whole mess could have been avoided if more attention had been paid to the little word ‘with’ in the above quotation.
There is no such disorder as gender dysphoria. It is a feeling or delusion that some children and adolescents have that they are in the ‘wrong’ body. This is a symptom, not a diagnosis, and should be treated as such, with compassion and understanding. It should never have been accepted at face value with the assumption that the next step, if desired, is a grotesque attempt to change a girl into a boy (or vice versa) – a biological impossibility.
See also this report from The Times of 17 June 2022.