Alabama, as well as other states, is currently struggling to define what is good and what is bad for children and teens who believe that they are not their true sex. “Gender identity” is one’s mental perception of sexuality and should not be confused with biological or true sex, which is unchangeable from conception. When gender does not align with biological sex, it is the true sex rather than the false gender identity that should be affirmed. Affirming a false belief is wrong. Unfortunately, that has been the approach taken by many healthcare professionals in recent years. It has resulted in skyrocketing false gender beliefs (“transgender and gender diverse”), adding substantially to the load of mental illness within and beyond Alabama’s borders.
The “affirmative” medical and surgical “care” that Senate Bill 10 is designed to stop are harmful and unethical. Such so-called “standard of care” interferes with normal sexual development and function, using substances that have never been tested in controlled trials with long-term follow-up. These substances (puberty blockers and hormones) have known harmful side effects, even when used for FDA-approved indications. Controlled studies have found significantly increased risks for dangerous blood clots (including strokes), heart attacks, and diabetes in “transgender persons” given those substances, even with limited time periods “treated” and followed. Sex “reassignment surgery,” such as removing healthy breasts, ovaries, and wombs from females, and castration of males so that they can “pass” as the opposite sex and feel more like their identified gender, is not only mutilating but most often sterilizing. Such surgery has also been found to increase suicide rates 19 times that of controls. Those who decide later that their gender really is their biological sex (and there are many who have) can never fully recover from the damage done from such surgery.
Those children and teens who believe that they are other than their true sex, which is identified (not “assigned”) at or before birth, need loving support to help them come to the truth; not affirmation of a lie that they can actually change their true sex. Physicians caring for these children should, by all means, continue caring for them, and not “abandon” them, but should care for them in the same ethical way (affirming truth) that was done decades ago when there were much fewer suicides and more sanity. The Vulnerable Child Compassion and Protection act (SB10) is best for the health and welfare of minors with this problem. It is a child abuse-deterrent act and is needed in Alabama and everywhere else.
Scott S. Field, MD
Den Trumbull, MD
Bill Whitaker, MD