Open letter to AMA, CHA, AAP discussing tactics of harassment, intimidation and threats of violence.
October 28, 2022
Dear American Medical Association, Children’s Hospital Association, and American Academy of Pediatrics,
On behalf of the American College of Pediatricians, the Association of American Physicians and Surgeons, the Catholic Medical Association, the Christian Medical and Dental Associations, the Coalition for Jewish Values Healthcare Council, the Coptic Medical Association of North America, and the National Association of Catholic Nurses, USA, we write this open letter in response to your correspondence dated
October 3, 2022, to Attorney General Garland. In that correspondence you voiced concerns that physicians who provide gender affirming medical interventions are being targeted by individuals and organizations who oppose this approach to alleviating suffering in individuals who experience gender dysphoria. You also claimed that there is “an intentional campaign of disinformation, where a few high-profile users on social media share false and misleading information.”
We fully agree that tactics of harassment, intimidation and threats of violence can never be justified. We join you in advocating for the elimination of these immoral activities. Many of our members have been the recipients of these same tactics of harassment, threats, intimidation, and job loss in efforts to bring attention to the major deficiencies in current data on the safety and efficacy of “gender affirming” medical interventions. We trust that you share with us a sincere desire to provide the highest quality of evidence-based medical care to children and adolescents who experience gender dysphoria. Yet there is a profound difference between eminence-based medicine and evidence-based medicine. We see ongoing active efforts to suppress any discussion of the merits of the existing data used to support gender affirming medical interventions to adolescents seeking to alter the appearance of their body to conform to their perceived gender identity. Such approaches are not only violative of the principle of scientific inquiry, but also of constitutionally protected free speech. Appeal to policy statements and practice guidelines generated by small committees of self-selected advocates representing a small percentage of professional organization membership falls short of the bar required to claim a strong evidence base.
We note that your professional organizations have failed to acknowledge the concerns raised in Finland, Sweden, the United Kingdom, France, and other countries regarding the low quality of data on the safety and psychological outcomes from the administration of GnRH agonists and sex incongruent sex-steroid hormones to adolescents with gender dysphoria. Furthermore, expression of concern over the ability of youth to understand and consent to irreversible surgical interventions that result in loss of fertility and adult sexual function does not constitute harassment or intimidation. The posing of these questions and concerns reflects the normal process of scientific and medical dialogue. Respectful debate and disagreement provide a basis for furthering scientific inquiry that leads to genuine improvement in medical care to the patients we serve.
We call upon each of your organizations, and other professional associations to join the organizations we represent in critical appraisal of the merits and limitations of current scientific evidence in the growing field of gender medicine. This should include a willingness to consider alternate hypotheses on both the etiology and optimal management of sex-gender identity discordance. The integrity of the scientific method and adherence to true evidence-based medicine depend upon genuine efforts to recognize and minimize bias, avoidance of contamination by ideological agendas, and a continual striving to elevate knowledge to the highest standards of excellence.
Dr. Patricia A. Sayers, DNP, RN
National Association of Catholic Nurses, USA